Journal of Gorgan University of Medical Sciences

Effect of Combined Resistance-Aerobic Exercise Training on the Wnt/Beta-Catenin Signaling Pathway and Bone Remodeling in a Rat Model of Aging

Yaser Kazemzadeh

Background and Objective: The beta-catenin (β-catenin) and T-cell factor 1 (TCF1) genes play a crucial role in bone development and remodeling. This study was conducted to determine the effect of combined resistance-aerobic exercise training on the Wnt/β-catenin signaling pathway and bone remodeling in a rat model of aging.
Methods: In this experimental study, 16 aged male Wistar rats (22 months old, weighing approximately 300–350 g) were randomly assigned to two groups: Control and training (n = 8 per group). Additionally, 8 young male rats (3 months old, weighing approximately 190–230 g) were included as a young control group. The training program consisted of eight weeks of combined resistance-aerobic exercise training program, with five sessions per week. Forty-eight hours after the final training session, the rats were anesthetized via intraperitoneal injection of ketamine and xylazine and subsequently sacrificed. Femoral bone tissue samples were isolated under sterile conditions. The expression levels of the target genes were evaluated using the real-time quantitative reverse transcription polymerase chain reaction (RT-PCR) method.
Results: Following eight weeks of combined resistance-aerobic exercise training, a statistically significant increase was observed in the expression of β-catenin and TCF1 genes compared to the aged group (P<0.05). Specifically, the expression levels of β-catenin and TCF1 genes in the aged training group demonstrated a significant statistical increase compared to the aged control group (P<0.05).
Conclusion: Performing combined resistance-aerobic exercise training for eight weeks resulted in a significant increase in the expression of β-catenin and TCF1 genes within the bone tissue of aged rats.

Effect of Minocycline on Behavioral-Cognitive Impairments Induced by Global Cerebral Ischemia

Masoud Fereidoni

Background and Objective: Stroke is considered one of the leading causes of mortality and disability worldwide. Excitotoxicity, neuroinflammation, and oxidative/nitrosative stress resulting from cerebral ischemia/reperfusion lead to cell death, cerebral edema, and cognitive-behavioral impairments, such as deficits in short-term and long-term memory. This study was conducted to determine the effect of minocycline on behavioral-cognitive impairments induced by global cerebral ischemia.
Methods: This experimental study was conducted on 56 male Wistar rats (weighing 220–280 g) at Ferdowsi University of Mashhad, Iran. The animals were randomly assigned to the following groups: Control, solvent, surgery, surgery + solvent + ischemia/reperfusion, surgery + ischemia/reperfusion, and minocycline-treated groups (administered intraperitoneally at doses of 11.25, 22.50, and 45 mg/kg/bw). At specified intervals following the surgical induction of global cerebral ischemia/reperfusion, a surgery procedure and a carotid artery occlusion method were employed for 20 minutes. Following a 30-minute interval post-procedure, the drug or solvent was injected intraperitoneally on day 0. These injections continued for seven consecutive days at a fixed time each day. On day 7, anxiety-like behavior was assessed using the open-field test. Subsequently, the Y-maze test was utilized to evaluate short-term memory, while the Morris water maze (MWM) test was employed to assess spatial long-term memory and reversal memory in the following days.
Results: In the Y-maze test, ischemia culminated in a 33% decrease in short-term memory performance (P<0.05). Minocycline at doses of 22.50 and 45 mg/kg/bw improved short-term memory by 20% and 25% compared to the ischemia group, respectively (P<0.05). In the open-field test, ischemia caused a 66% decrease in time spent in the center of the field, indicating increased anxiety (P<0.05). Minocycline at a dose of 45 mg/kg/bw reduced anxiety by 32% compared to the ischemia group (P<0.05). In the MWM test, ischemia significantly increased the time to find the platform on days 2 and 4 (P<0.05). Minocycline at doses of 22.50 and 45 mg/kg/bw significantly decreased the time to find the platform (P<0.05). In the reversal phase of the MWM test, ischemia led to a decline in long-term memory performance (P<0.05), while minocycline at doses of 11.25, 22.50, and 45 mg/kg/bw significantly improved performance (P<0.05). In the probe trials, ischemia reduced the time spent in the target quadrant by 54% in probe 1 and 47% in probe 2 (P<0.05). Minocycline at 45 mg/kg/bw increased the time spent in the target quadrant by 45% in probe 1 and 34% in probe 2 (P<0.05). No statistically significant changes in motor activity were observed between the groups.
Conclusion: Minocycline, particularly at doses of 22.50 and 45 mg/kg, significantly improves cognitive function, memory, and anxiety without inducing motor activity impairments following cerebral ischemia.

Effects of Eight Weeks of Conventional Corrective Exercises and Corrective Games on Agility, Power, and Dynamic Balance in Male Students with Genu Varum

Saeed Shahrani

Background and Objective: Genu varum is one of the most prevalent postural deformities resulting from the deviation of the knee alignment from its natural state. This study was conducted to investigate the effects of eight weeks of conventional corrective exercises and corrective games on agility, power, and dynamic balance in male students with genu varum.
Methods: This field trial was conducted on 42 male students, aged 10–13 years, with genu varum in Koohrang County, Chaharmahal and Bakhtiari Province, Iran, during the 2021–2022 academic years. Genu varum was diagnosed using a caliper based on a femoral intercondylar distance exceeding 2 cm. Participants were assigned via a simple randomization method into three groups (n = 14 per group): A control group (no intervention), a conventional corrective exercises group (a selected program consisting of 7 exercises), and a corrective games group (a selected program consisting of 4 games). Agility, power, and dynamic balance variables were assessed using the 4×9 m shuttle run, Sargent jump, and Y-balance tests during the pre-test and post-test phases, respectively.
Results: The degree of genu varum correction in the corrective games group (10.57±4.18 mm) was significantly higher than that of the conventional corrective exercises group (5.43±2.65 mm) (P<0.05). Indicators of agility, power, and dynamic balance of the dominant lower limb showed significant statistical improvement in both the conventional corrective exercise and corrective games groups compared to the control group (P<0.05). However, no significant statistical difference was observed between the two groups regarding the improvement rate of these indicators.
Conclusion: While both conventional corrective exercise and corrective game interventions led to a relative reduction in genu varum deformity, the degree of improvement was significantly more pronounced in the corrective games intervention.

Prevalence of Residual Symptoms Following Thyroid-Stimulating Hormone Normalization in Patients with Hypothyroidism

Fatemeh Mohmmadzade

Background and Objective: Hypothyroidism is a clinical syndrome resulting from a deficiency in thyroid hormone production. Despite achieving normalized thyroid-stimulating hormone (TSH) levels through levothyroxine (LT4) therapy, many patients continue to experience residual symptoms. This persistence raises questions regarding the adequacy of standard monotherapy and suggests that alternative treatments, such as combination therapy (LT4 and liothyronine [LT3]), may be more effective for certain individuals. This study was conducted to determine the prevalence of residual symptoms after TSH normalization in patients with hypothyroidism in Gorgan, Iran.
Methods: This descriptive-analytical study was conducted on 200 patients (193 females, 7 males; mean age = 41.81±12.25 years) with a confirmed diagnosis of hypothyroidism who were under regular treatment and had normalized TSH. Subjects were recruited from those referring to an endocrinology subspecialty clinic in 2022 in Gorgan. Eligible participants were asked to complete a checklist assessing common symptoms of hypothyroidism, including fatigue, dry skin, weight gain, cold intolerance, constipation, muscle cramps, facial puffiness, and hair loss. Paraclinical data, including TSH and thyroid peroxidase antibody (anti-TPO) levels, were also collected.
Results: The most prevalent residual symptoms of hypothyroidism were fatigue (74.2%), cold intolerance (73.7%), and dry skin (73.2%). A statistically significant correlation was found between body mass index (BMI) and dry skin (P<0.05). However, no significant correlation was observed between TSH levels and the persistence of symptoms.
Conclusion: Despite TSH normalization, symptoms of hypothyroidism-including fatigue, cold intolerance, and dry skin-persist in more than 70% of cases.

Radiological Evaluation of Sphenoid Sinus Anatomical Characteristics Using Computed Tomography Scan

Rouzbeh Shams Amiri

Background and Objective: The sphenoid sinus is one of the four paranasal sinuses located within the sphenoid bone and plays a crucial role in pituitary gland surgeries. This sinus is in close proximity to vital structures, including the internal carotid artery and the optic nerve. This study was conducted to radiologically evaluate sphenoid sinus anatomical characteristics using computed tomography (CT) scans of patients referring to selected imaging centers in Gorgan, Iran.
Methods: This descriptive-analytical study was conducted on 180 patients (100 females and 80 males; mean age = 35.69±13.07 years) referring for paranasal sinus CT scans or head and neck CT scans, prescribed by a specialist physician, to the Fifth Azar Educational-Therapeutic Center and Izadi Imaging Center in Gorgan, Iran, during July and August 2020. The sphenoid sinus volume and anatomical characteristics, including the type of pneumatization, presence of septa, and carotid canal protrusion and adhesion, were examined via CT imaging.
Results: Regarding the frequency distribution of sinus types based on the site of pneumatization, 151 cases (83.8%) were postsellar, 25 (13.8%) were sellar, and 4 (2.2%) were presellar. The mean volume of the left sinus and the total sinus volume were significantly higher in men than in women (P<0.05). Carotid canal adhesion to the sphenoid sinus was observed in 20 patients (11.1%). No significant statistical difference was found between genders regarding the distribution of carotid canal adhesion, presence of accessory septa, or carotid canal protrusion. Similarly, the pneumatization of the anterior clinoid process, pterygoid process, and the greater and lesser wings of the sphenoid showed no gender-based significant differences. A significant statistical correlation was observed between left carotid protrusion and the pneumatization of the greater and lesser wings of the sphenoid, as well as pterygoid and anterior clinoid processes (P<0.05). On the right side, this correlation was not present with the pneumatization of the lesser wing. Regarding carotid canal adhesion, a significant correlation was only found with the pneumatization of the left pterygoid process (P<0.05).
Conclusion: The most common form of the sphenoid sinus was the postsellar type, and the mean total and left sinus volumes were greater in men. Gender was not found to be a reliable predictor for the extensive variations and high diversity of the sphenoid sinus anatomical characteristics.

Relationship of Antral Follicle Count and Anti-Mullerian Hormone with Ovarian Response in Infertile Women

Moghadaseh Jahanshahi

Background and Objective: Pregnancy success in infertile women depends on various factors, including oocyte quality, immunological factors, and endometrial receptivity. To evaluate ovarian reserve, parameters such as age, follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH), and antral follicle count (AFC) are considered. This study was conducted to determine the relationship of AFC and AMH with ovarian response in infertile women referring to an infertility center.
Methods: This descriptive-analytical study was conducted on 50 women (mean age = 33.88±5.32 years) who were candidates for assisted reproductive technology (ART) at the Nahal Infertility Center, Shahid Sayad Shirazi Hospital, in 2020. Serum levels of AMH, FSH, luteinizing hormone (LH), complete blood count (CBC), liver function tests (LFTs), thyroid function tests (TFTs), blood urea nitrogen (BUN), creatinine (Cr), and prolactin (PRL) were measured using enzyme-linked immunosorbent assay (ELISA), while FSH levels were measured via radioimmunoassay (RIA). Transvaginal ultrasound was performed on the third day of the menstrual cycle to determine the AFC.
Results: The mean duration of infertility was 4.8±2.8 years. Thirty-three women (66%) had primary infertility, and in 35 cases (70%), the cause of infertility was related to female factors. The mean and standard deviation serum levels of AMH and AFC were 4.8±4 ng/ml and 9±5 ng/ml, respectively. Poor ovarian response to treatment was observed in 8% of cases. Ovarian response showed a statistically significant correlation with AFC (P<0.05). Furthermore, AFC and AMH indices had significant statistical correlations with the ovarian response (P<0.05).
Conclusion: The AFC and AMH indices can be considered reliable predictors of ovarian response in infertile women.

Determining the Protective Effect of L-Arginine Against Amikacin-Induced Nephrotoxicity in Normal African Green Monkey Kidney Epithelial Cells by Evaluating Oxidative Stress Parameters

Mohammad Shokrzadeh

Background and Objective: Due to high metabolic activity and rich blood supply, the kidneys are exposed to high levels of reactive oxygen species (ROS) under pathological conditions, making them highly vulnerable to oxidative stress. Nephrotoxic agents, such as cisplatin, aminoglycosides, and radiocontrast agents induce the production of ROS in renal tubular cells, leading to lipid peroxidation, protein oxidation, and mitochondrial dysfunction. This study was conducted to determine the protective effect of L-arginine against amikacin-induced nephrotoxicity in normal African green monkey kidney epithelial cells (Vero) by evaluating oxidative stress parameters.
Methods: This descriptive-analytical in vitro study was conducted on Vero cell lines purchased from the National Genetic Resources Cell Bank. For all assays, the amount of cultured calls was 10⁵. Prior to the induction of nephrotoxicity with amikacin (653.2 µg/mL), the cells were pre-treated for 24 hours with various concentrations of L-arginine (108, 216, 430, and 860 µM). Subsequently, to evaluate the effect of L-arginine on oxidative stress status, the variables of malondialdehyde (MDA), cell viability, and ROS were measured.
Results: In the assays for ROS levels and cell viability, all tested concentrations of L-arginine (108, 216, 430, and 860 µM) resulted in a significant reduction in ROS levels (30±1.5, 28±1.4, 25±1.2, and 21±1.0, respectively) and a significant increase in cell viability (55±5.2, 64±3.8, 72±2.9, and 84±4.7, respectively) (P<0.05). Regarding measurement tests of lipid peroxidation, L-arginine at 108 µM did not significantly reduce MDA levels; however, other concentrations (216, 430, and 860 µM) significantly decreased MDA levels to 0.80±0.02, 0.74±0.03, and 0.66±0.01, respectively (P<0.05).
Conclusion: The findings of this study demonstrate the ability of L-arginine to improve kidney cell viability parameters and increase glutathione (GSH) levels at all tested concentrations (108, 216, 430, and 860 µM). Furthermore, L-arginine at concentrations of 216, 430, and 860 µM significantly reduced lipid peroxidation.

Weight Changes During Tuberculosis Treatment and Associated Factors: A Historical Cohort Study in Golestan Province, Iran (2020)

Naser Behnampour

Background and Objective: Tuberculosis (TB), caused by a bacterium called Mycobacterium TB, is the most prevalent infectious disease leading to mortality worldwide. Weight loss is frequently observed in TB patients at the time of diagnosis. Body weight changes have been identified as a potential predictive marker for TB treatment outcomes, particularly in drug-susceptible cases. This study was conducted to evaluate weight changes during TB treatment and associated factors in Golestan Province, Iran.
Methods: This historical cohort study was conducted on 348 patients (178 males and 170 females) with TB referring to health centers in Golestan Province, Iran, in 2020. Data including age, gender, type of TB, pre- and post-treatment weight, place of residence (urban or rural), and treatment outcomes were extracted from patients’ medical records in the TB Register System. Weight changes were then compared before and after treatment across three groups: Smear-positive pulmonary TB, smear-negative pulmonary TB, and extra-pulmonary TB.
Results: Patients’ post-treatment weight showed a statistically significant mean increase of 1.98 kg (P<0.05). Based on the grade of sputum smear positivity, post-treatment weight gain was higher in pulmonary TB patients (both smear-positive and smear-negative) compared to extra-pulmonary cases. Overall, weight gain in all three groups (smear-positive pulmonary TB, smear-negative pulmonary TB, and extra-pulmonary TB) was statistically significant (P<0.05). Furthermore, weight gain was significant across all groups of sputum smear positivity (+ to +++) (P<0.05), with the most substantial weight changes occurring in patients with a ++ sputum smear. Mean weight gain was also significant in both smear-negative patients and other categories (P<0.05), with smear-negative individuals showing higher weight gain than other states. Although weight gain was slightly higher in men than in women, it was statistically significant in both genders (P<0.05). Weight gain was significant in both urban and rural residents (P<0.05), with rural patients exhibiting more pronounced weight gain. Significant weight gain was observed across individuals under 15, 15–65, and over 65 years of age (P<0.05). The least weight changes were observed in the over 65 age group, while the most significant changes occurred in those under 15.
Conclusion: The type of TB (pulmonary versus extra-pulmonary), the grade of sputum smear positivity, treatment outcomes, gender, place of residence, and age were identified as factors associated with weight changes in patients with TB.

Protective Effects of Lycopene and Coenzyme Q10 Against 5-Fluorouracil-Induced Genotoxicity in SW480 (Colorectal Cancer) and Bone Marrow Mesenchymal Stem Cells Cell Lines: A Comet Assay Study

Mohammad Shokrzadeh

Background and Objective: 5-fluorouracil (5-FU) is a widely used chemotherapeutic agent for colorectal cancer treatment; however, its genotoxicity can lead to deoxyribonucleic acid (DNA) damage in healthy cells. Lycopene and Coenzyme Q10 are natural antioxidants capable of exerting protective effects against oxidative damage. This study was conducted to determine the protective effect of lycopene combined with Q10 against 5-FU-induced genotoxicity in colorectal cancer (SW480) and bone marrow mesenchymal stem cells (MSCs) cell lines using the Comet assay.
Methods: This descriptive-analytical study was conducted on SW480 and MSCs cell lines obtained from the Iranian Genetic Resources Cell Bank at the Cell Culture Laboratory of the Faculty of Pharmacy in 2023. The SW480 and MSCs cell lines were cultured at a density of 10⁴ and exposed to a single dose of 5-FU (1 µM) along with various concentrations of lycopene and Q10 (0, 10, 20, and 30 µM). For each cell line, seven groups were defined: A control group (without treatment); a 5-FU group at optimum concentration (1 µM); groups receiving Q10 at 10, 20, and 30 µM plus lycopene at 10, 20, and 30 µM, respectively, comined with receiving 5-FU at optimum concentration (1 µM); a group receiving Q10 alone (30 µM); and a group receiving lycopene alone (30 µM). Cytotoxicity was evaluated using 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay, and DNA damage was assessed via the Comet assay.
Results: 5-FU caused a significant decrease in cell viability and a significant increase in DNA damage (P<0.05). Lycopene and Q10 alone did not exhibit significant cytotoxicity. The combination of lycopene and Q10 with 5-FU culminated in increased cell viability and decreased DNA damage compared to the group treated with 5-FU alone.
Conclusion: Lycopene and Q10 demonstrated significant protective effects against 5-FU-induced genotoxicity in both SW480 and MSCs cell lines.

Clinical Characteristics, Outcomes, and Predictors of Disease Severity in Hospitalized Coronavirus Disease 2019 Patients: A Cross-Sectional Study in Gorgan, Iran (2021)

Alireza Tahamtan

Background and Objective: The coronavirus disease 2019 (COVID-19) pandemic has revealed significant variability in clinical outcomes driven by demographic, geographic, and underlying factors, highlighting the need for a better understanding of disease progression. This study was conducted to determine the clinical characteristics, outcomes, and predictors of disease severity among hospitalized COVID-19 patients in Gorgan, Iran.
Methods: This descriptive-analytical, cross-sectional study was conducted on the data of 736 hospitalized COVID-19 patients (58.6% male; mean age = 55 years; age range = 1–94 years) at the Fifth Azar Educational-Therapeutic Center in Gorgan during 2021. A convenience sampling method was employed, and patients were selected based on the completeness of their electronic medical records. Patients were categorized based on disease outcome (recovery/death) and disease severity (intensive care unit [ICU] admission/general ward admission). Demographic data, symptoms, and comorbidities were extracted from electronic health records. Inclusion criteria consisted of a confirmed diagnosis via reverse transcription quantitative polymerase chain reaction (RT-qPCR), while exclusion criterion included incomplete data or transfer to other medical centers.
Results: The mortality rate was 31.3%, occurring predominantly in the older adult age group (P<0.05). Due to disease severity, 21.2% of cases required ICU admission. Dyspnea was significantly associated with both mortality and disease severity (P<0.05). The prevalence of dyspnea was 62.6% among deceased patients compared to 37.4% in recovered patients. Comorbidities, such as cardiovascular diseases and chronic obstructive pulmonary disease (COPD), were significantly associated with increased mortality (P<0.05).
Conclusion: Old age and specific comorbidities were identified as key predictors of severe outcomes. Early identification of symptoms, particularly dyspnea, and targeted interventions are essential for high-risk groups.