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Background and Objective: Various infections and the formation of stones could be the cause for bile duct obstruction of that sterile organ. Determination of pathogenesis factors and the bacteria involved in infections are important in the prevention of disease, and cares needed following surgery. This study was done to determine the bacteria in the gallbladder of patients with cholelithiasis and evaluation of pathogenic factors of the prevalent isolated bacteria.
Methods: In this descriptive laboratory study, 35 samples of gallbladder tissues which contained gallstones were collected under sterile conditions in “Department of General Surgery of Imam Khomeini Hospital”, Tehran, Iran during 2016. The stone types were analyzed and decomposed by chemical procedures, and the bacteria existed in the tissues were also identified using biochemical experiments. The tissues with negative results in microbiological studies were looked for any contaminating bacteria, applying the DNA extracted from gallbladder tissue as a template using F27 and R1492 as the primers for PCR (Polymerase Chain Reaction) amplification of 16SrRNA gene. Those with the positive results of microbiological tests were subjected to the DNA sequencing following gel purification and blasted against the NCBI gene database. The most frequently isolated bacteria were studied according to the intensity of biofilm formation, using the microtitre plate method. CsgF and Ag43 (Flu), the genes involved in the induction of such phenotype were also analyzed in this study. The antibiotic resistance assay of the isolates was performed using disc diffusion procedure.
Results: Thirteen out of thirty five samples of post-surgery gallbladder tissues were found to be infected by different bacteria, including: Klebsiella (3 cases), Escherichia coli (4 cases), Enterobacter (1 case), Staphylococcus aureus (2 cases), Enterococci (2 cases), and Streptococcus (1 case). In 23 out of 35 samples (65.7%), no bacteria could be isolated using microbiological methods. However, in seven out of 23 samples, the amplified 16SrRNA had an indication of Klebsiella (6 cases) and Enterococcus (1 case) isolates. Therefore, the most prevalent genus in gallbladder infections was Klebsiella (47.36%). Chemical analysis showed that the highly frequent compound of gallstones (98%) were of cholesterol and bilirubin. Escherichia coli with fourcases were the highest culture growing isolated bacteria, in all of which, the biofilm formation genes were present. In the two out of four Escherichia coli isolates the intensity of biofilm formation was high. Although, in the remaining two isolates was medium. While, they were found to be sensitive to the most of the antibiotics, they showed resistance to Tetracycline, Ciprofloxacin and Ceftazidime in different ranges.
Conclusion: The present study provided evidence that non-cultural bacteria are hihly present in gallbladder infections. The high potential of the commonly isolated bacteria in biofilm formation should be taken as a warning to follow the precise protocol of antibiotic prescription for treatment of gallbladder infections.

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Background and Objective: Children with ADHD suffer from motor impairment in addition to behavioral problems (hyperactivity/impulsivity, attention deficit).The cerebellum receives data from visual, vestibular and somato- sensory systems.This study was done to determine the correlation between kinetic parameters of balance performance and behavioral symptoms in children with attention-deficit/hyperactivity disorder.
Methods: This case - control study was performed on 15 children with ADHD (9.21±0.69 year) and 15 healthy children (9.27±0.75 year). Kinetic parameter of balance evaluated using sensory organization test (SOT) in different sensory conditions including visual, somatosensory and vestibular by Neurocom. Conner’s questionnaire used to assess hyperactivity and attention deficit in addition to a psychologist.
Results: Dynamic balance score in ADHD children was significantly lower in compare to controls (p<0.05). Children with ADHD had kinetic parameters of balance performance abnormality in compare to controls. There was a significant correlation between sensory contribution and hyperactivity in children with ADHD (P<0.05).
Conclusion: Children with ADHD suffer from balance dysfunction which is a result of sensory integration and attention deficit. The sensory systems analysis showed that vestibular system, partially somatosensory dysfunction is the most important factor in balance disorder in children with ADHD.

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Background and Objective: Patellofemoral pain is the most common and controversial musculoskeletal problem. Several studies have focused on its causes, prevention, and treatment strategies. This study was done to determine the effect of eight weeks of standard and functional stabilization training on pain and functional movement of women with patellofemoral pain.
Methods: This quasi-experimental study was performed on 45 non-athletic women with patellofemoral pain syndrome aged 18-35 years. Subjects were divided into three standard, functional stabilization training and the control group and followed for 8 weeks. Pain was measured by visual analogue scale and functional movement was measured by the KUJALA (Anterior knee Pain Scale).
Results: Severity of pain significantly reduced in the two interventional groups (standard and functional stabilization training) in comparison with control group (P<0.05). Functional movement significantly increased in the two interventional groups in comparison with control group (P<0.05). Severity of pain and functional movement had no significant difference between the two intervention groups.
Conclusion: Performing each of the exercises, standard or functional stabilization training, for eight weeks, had beneficial effect on reducing pain and improving functional movement in patients with patellofemoral pain syndrome.

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Background and Objective: Infantile colic which can cause nervousness and anxiety in parents by fussing and restlessness in babies. This study was done to determine the prevalence and associated risk factors of infantile colic in Babol, the North of IRAN.
Methods: This descriptive-analytical study was done on 591 breastfeeding babies (321 females, 270 males) born with birth weight 2500-4000 grams and gestational age ≥37 weeks without any medical problem during 2016-18. They visited in age 2, 4, 8, 12 weeks by neonatologist. On the basis of parents complain and Wessel's criteria babies were divided into three groups: Cramp with crying (colicky group), Cramp without crying and normal group. Then possible risk factors of infantile colic have been compared in three groups.
Results: 45.5% of babies presented cramp with crying as colic group. Time of restlessness was significantly more than morning during night and afternoon (P<0.05). Colic was higher in infants born by cesarean section (P<0.05), and in the first-born child (P<0.05). However, there was not significant relation with gender, mothers’ education, parents smoking and taking dairy product.
Conclusion: According to this study’s findings, nearly half of infants had the symptoms of colic, which was higher in first children, infants born by cesarean section and during night.

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Background and Objective: Perinatal mortality rate (PMR) is one of the main indicators in evaluation of health community and healthcare systems. This study was performed to determine the perinatal mortality rate in the referral third level of maternal and infant care center affiliated to Babol University of Medical Sciences.
Methods: This descriptive-analytical study was performed on by cross-sectional method and 19234 births (9751 male and 9483 female) from 22 weeks gestation to 29 days after delivery Ayatollah Rouhani Hospital in Babol, northern Iran during 2011-18. Data on the cause of neonatal death, maternal age, type of delivery, malformations, maternal underlying disease, maternal pregnancy-related conditions, and diseases at the time of death in neonate were collected from website of the Ministry of Health. Then each of the indicators was calculated per 1000 live births.
Results: In this study, the PMR was calculated per 1000 live births which was 29.01 (boys 16.17 and girls 12.84). The portion of vaginal delivery was 9.67 and cesarean section was 19.34. Out of 558 perinatal deaths, 59.9% died due to intrauterine death with an index of 17.37 and 40.1% of deaths were due to infant death with an index of 11.63. Most neonatal deaths (74%) occurred within the first 24 hours of birth and in terms of gestational age 86.02% were <37 weeks of gestation with an index of 24.95, and low birth weight were 83.8% with an index of 24.31. Underlying disease was found in 25.6% of mothers and pregnancy-related conditions in 74.4% of cases. Fetal distress in 14.4% with an index of 4.20 was the most common disease associated with infant death or cause of death in preterm infants. Other causes of perinatal death were specific disorders of perinatal origin, birth defects, chromosomal abnormalities, and accidents were 10.09, 4.06, and 0.58 per 1000 live births, respectively.
Conclusion: The most and important factors of prenatal mortality wrer prematurity and low birth weight that major causes include maternal pregnancy-related conditions and maternal underlying disease, Therefore, emphasis on adequate prenatal care, identification and follow-up of mothers with underlying diseases can be effective in reducing perinatal mortality.

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Background and Objective: Cancer can spread to distant parts of the body through the lymphatic system or bloodstream. Angiogenesis is a fundamental step in the transition of tumors from a dormant state to a malignant. Some changes in cancerous cells can be improved and treated using herbal extracts. Salvia species in Iranian traditional medicine were used against various infections, inflammatory diseases.This study was done to evaluate the effect of aqueous extract of Salvia atropatana leaf on subcutaneous tumor model of CT26 colon carcinoma in Mice.
Methods: In this experimental study, for the induction of colon carcinoma, 26CT cells were injected into 18 BALB/c male Mice. Subcutaneous injection was done in the right side of the animal. When the size of the tumor was 50±350 mm3, 18 Mice were randomly allocated into 3 groups, including controls, aqueous extracts a breakdown of each dose 50 and 100 mg/kg/bw. The group containing the aqueous extracts of Salvia atropatana leaf was injected for 14 days, daily. To monitor the therapeutic effects, the parameters of the stopping rate in the growth of the tumor, the relative volume changes and the doubling of tumor volume were evaluated. After sacrificed the animals at the end the fourteenth day of the study, tumors were dissected for histological study.
Results: The volume of tumors and the mean density of the number of vessels was significantly reduced in treated group 1 (50 mg/kg/bw of aqueous extracts of Salvia atropatana leaf) and treated group 2 (100 mg/kg/bw of aqueous extracts of Salvia atropatana leaf) in compared to control group (P<0.05). Reduction in density of cells and vascular sections was significantly reduced in treated group 1 (50 mg/kg/bw of aqueous extracts of Salvia atropatana leaf) and treated group 2 (100 mg/kg/bw of aqueous extracts of Salvia atropatana leaf) in compared to control group (P<0.05).
Conclusion: Aqueous extracts of Salvia atropatana leaf has anti-angiogenesis activity and significant inhibitory effects on tumor growth in animal model.

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Background and Objective: Campylobacter is one of the most important pathogens causing bacterial gastroenteritis, which is usually transmitted through the food of animal origin. This study was done to evaluate the status of Campylobacter in diarrheal food outbreaks compared to other microbial agents.
Methods: This descriptive study was performed on 305 diarrheal swab samples from 102 food outbreaks during six months from spring to the end of summer 2018. Presence of Campylobacter species were assessed according to the protocol of the General Directorate of Laboratory Affairs.
Results: Out of 305 samples, 8 (2.6%) were identified as Campylobacter species, 3 (37.5%) Campylobacter and 5 (62.5%) Campylobacter coli. The epidemiology of the outbreaks showed that female (54.5%), average age of 16-30 years (28.2%), consumption of salads and vegetables (16.1%) and living in the cities (59.7%) were the most cases.
Conclusion: This study showed that in addition to classic pathogens such as Salmonella, Shigella, Escherichia coli, attention also should be paid to Campylobacter bacteria. In addition, recognizing epidemiological factors can play an important role in preventing and controlling food outbreaks.

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Background and Objective: One of the most common complications of mild cognitive impairment is increased body sway and falls. This study was performed to evaluate the effect of Pilates training on control posture in patients with mild cognitive impairment.
Methods: This clinical trial study was performed on 30 women with mild cognitive impairment who referred to elderly Research Center in Kermanshah city, north-west of Iran during 2019. Subjects were randomly divided into two groups including Pilates Training and control groups. Pilates training group was trained for eight weeks, 3 sessions per week and duration for each session was one hour. The control posture of the subjects before and after the exercise was evaluated.
Results: There was significant difference in obtained scores in the size and distance of the center of pressure area range with open and closed eyes in the intervention group, prior and after training (P<0.05). The mean postural control (the size and distance of the center of pressure area range with open and closed eyes) reduced after 8 weeks of Pilates exercises in the intervention group in compared to control group (P<0.05).
Conclusion: Pilates training is effective in improving postural control in patients with mild cognitive impairment.

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Background and Objective: The incidence of tuberculosis in Golestan province in northern Iran is 26.7 cases in 100000 persons. Lack of energy and nutrients is one of the reasons for the increased risk of tuberculosis. Malnutrition is an important cause of high mortality in the Tuberculosis (TB) population. With decreasing level of visceral proteins, anthropometric indices, and micronutrients increase the risk of mortality. This study was performed to determine the status of nutritional status of patients with Tuberculosis in Gonbad-e-Kavous, north of Iran during 2014.
Methods: This descriptive-analytical study was performed on 45 pulmonary tuberculosis patients with mean age of 57±20 living in Gonbad city, north of Iran during 2014. Demographic information and history of tuberculosis, body mass index, albumin, hemoglobin, total protein and blood cell count and food intake were recorded for each patient.
Results: 58% of patients were women. 52% of patient was resident in rural area. There was a significant difference in terms of body mass index and previous history of tuberculosis in patients with different disease intensities. Among patients with different disease intensities, the difference in the distribution of anemia severity was not significant. There was no significant difference between the two sexes in terms of disease severity distribution. According to the fitted regression model, the age variable, even in the presence of other variables, had a significant effect on disease severity (P<0.05).
Conclusion: With increasing disease severity, patients' BMI decreases and the severity of malnutrition and anemia increases. The severity of the disease increases with age. Tuberculosis patients need nutritional support.

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Background and Objective: Thyroid cancer is a common cancer of the endocrine system, and knowing the etiology can be effective in its treating. On the other hand, the FNA technique is not accurate enough, so finding a biomarker for thyroid cancer is of importance. This study was done to evaluate the NKX2-1 gene as indicator of differentiation of papillary thyroid carcinoma (PTC).
Methods: In this case-control study, 17 fresh PTC tissue samples and 20 adjacent-healthy tissues were collected during thyroidectomy in Isfahan, Iran. RNA extraction was followed by cDNA synthesis. The expression of the NKX2-1 gene was performed using specific primers (exon-junction and intron spanning) using the RT-qPCR method.
Results: An examination of the quality and quantity of extracted RNAs showed that they were intact and suitable for making cDNA. Examination of the melting curve showed a specific amplification of the NKX2-1 gene. The difference in expression of the NKX2-1 gene between PTC and healthy-adjacent tissues was 0.947.
Conclusion: No difference in the expression of the NKX2-1 gene between the healthy tissue adjacent to the tumor and the tissue of the PTC tumor indicates that the PTC tumors were differentiated.

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Background and Objective: Since the onset of the COVID-19 (Corona Virus Disease 2019) pandemic, several challenges have been proposed to the disease and the causing viral agent. Accurate and rapid diagnosis of the virus is essential to control the spread and progression of the disease. Choosing a suitable sample in different phases of the disease will reduce the false-negative results. This study was performed to identify the SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) genome in the blood samples of COVID-19 patients.
Methods: This descriptive-analytical study was performed by census method on 100 whole blood samples of patients (50 recovery and 50 deceased) with a definitive diagnosis of COVID-19 (positive Real-Time RT-PCR test of nasopharyngeal swab samples) admitted to Shahid Sayyad Shirazi educational and medical center in Gorgan during 2020-21. Clinical and laboratory findings were compared in the two groups of patients. The viral nucleic acid was extracted from the whole blood samples of the patients, and the presence of the virus genome was investigated using primer and probes via the Real-Time RT-PCR method.
Results: The age of the recovered patients (49.06±15.1 years) was significantly was lower than deceased patients (58.3±12.4 years) (P<0.05). Clinical symptoms including cough, shortness of breath, sputum secretion, and vomiting in deceased patients were significantly more than recovery group (P<0.05). The lymphocytes count and platelet level in the deceased group were lower than in the recovered group. Level of lactate dehydrogenase (LDH) was higher in the deceased group in compare to recovered group (P<0.05). The virus genome identified in the blood samples of 7 patients (3 recovered and 4 deceased), which had no significant relationship with the outcome of the disease.
Conclusion: The use of blood samples for the diagnosis of COVID-19 is not appropriate.

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Background and Objective: Yersinia is water and foodborne organism that cause human gastroenteritis. This study was done to evaluate the frequency of Yersinia species isolated from children diarrheal samples and chicken meat in Tehran, Iran.
Methods: In this descriptive study 250 sample of diarrhea of children referred to the Children's Medical Center, Tehran, Iran and 250 samples of chicken were collected and examined for Yersinia infection during July 2016 to March 2017. Isolation method was performed based on initial enrichment in phosphate buffer for 3 weeks in refrigerator (cooling in c4 +) and then using KOH as secondary enrichment and culture on CIN agar medium. Biotyping method was used to determine pathogenic strains.
Results: In this study, 5(2%) isolates from pediatric diarrhea samples and 20 isolates (8%) from chicken meat samples were obtained from Yersiniaenterocolitica. Biotyping of human Yersiniaenterocolitica isolates identified 3 cases of biotype 1A, one case of biotype 1B, one case of biotype 2 and from chicken meat isolates, 16 isolates belonged to biotype 1A and 4 isolates belonged to biotype 1B.
Conclusion: Presence of common pathogenic 1B and non-pathogenic 1A biotypes in pediatric diarrhea samples and chicken meat can indicate the cause of diarrhea in children.
 

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Background and Objective: Puberty is a period of transition from childhood to adulthood which is accompanied by physiological changes. Menarche age is an important puberty indicator for assessing growth status. Growth and maturity of the genitals are essential for a girl's reproductive health. This study aimed to investigate the relationship between uterine sonographic characteristics and dimensions with menarche and puberty in girls.
Methods: This descriptive-analytical study was performed on 76 healthy girls (aged 9-16 years) who were referred to the endocrinology clinic of Taleghani Hospital in Gorgan (Iran) during 2017-2020. Height, weight and age were recorded and uterine and ovarian dimensions were measured by pelvic sonography.
Results: There was a significant positive correlation between menarche age (r=0.79, P=0.001) and ovarian length (r=0.81, P=0.007), ovarian volume and the length of the largest side of the uterus (r=0.77, P=0.001). Height had a significant positive association with menarche age (b=0.082, P=0.002) and ovarian length in the second place (b=0.097, P=0.004). But there was an inverse relationship between menarche age and girls' weight.
Conclusion: An increase in the menarche age increases the size of the uterus and its volume.
 

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Background and Objective: Acrylamide is a neurotoxic agent that increases oxidative stress by creating an imbalance between the production and removal of free radicals, which in turn contributes to the pathogenesis of some neurodegenerative disorders. Thymoquinone extracted from Nigella satvia has prominent antioxidant effects. The objective of this study was to evaluate the effects of thymoquinone on hippocampal oxidative stress and neuronal density following acrylamide administration in male rats.
Methods: In this experimental study, 28 male Wistar rats aged 10-12 weeks and weighing 180-200 g were randomly divided into 4 groups of 7 rats: control, acrylamide, acrylamide + thymoquinone treatment (1 mg/kg), and acrylamide + thymoquinone treatment (5 mg/kg). For induction of brain injury, 50 mg/kg of acrylamide was injected intraperitoneally. Two days after the acrylamide injection, the rats were sacrificed, and malondialdehyde (MDA), glutathione (GSH), and catalase levels were measured in hippocampal homogenate. Evaluation of neuronal density in hippocampal CA1 region was also performed by Nissl staining.
Results: Acrylamide injection significantly increased MDA level and reduced GSH content and catalase activity in comparison with the control group (P<0.05). Administration of 5 mg/kg thymoquinone significantly reduced MDA level (P<0.05) but improved GSH and catalase activity in comparison with the acrylamide group (P<0.05). In addition, neuron density of hippocampal CA1 region did not differ significantly between the groups.
Conclusion: Thymoquinone can attenuate oxidative stress markers in a dose-dependent manner.
 

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Background and Objective: Genu recurvatum deformity shifts the mechanical axis of the lower extremity posteriorly, which may disturb balance and stability. The goal of this study was to compare the balance and core stability of female students with and without genu recurvatum.
Methods: This case-control study was conducted on 25 female students with genu recurvatum (mean age: 14.88±0.6 years) and 25 healthy counterparts (mean age: 15±0 years) in city of Salmas (Iran). The criterion for genu recurvatum was a 5-degree knee hyperextension. To measure static and dynamic balance, we used the stork balance stand test and Y test, and to measure core stability, we used the Sorensen, plank, side plank, and 60-degree sitting tests.
Results: The mean values of static balance of dominant (19.86±3.64) and non-dominant (17.16±4.67) leg of healthy students were significantly higher than that of students with genu recurvatum (14.44±2.03 and 10.53±1.66, respectively) (P<0.05). The median values of the dynamic balance of the dominant (32.04) and non-dominant (31.84) leg of healthy students were significantly higher than that of students with genu recurvatum (18.96 and 19.16, respectively) (P<0.05). The median values of central stability for the Sorensen (30.40), plank (30.58), lateral plank (31.04), and sitting (34.12) tests in healthy students were significantly better than the median values of central stability for the Sorensen (42.60), plank (20.20), lateral plank (19.96), and sitting (16.88) tests in students with genorcorvatum (P<0.05).
Conclusion: The balance and core stability of female students with genu recurvatum deformity is poor compared to their healthy counterparts.
 

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Background and Objective: A basic factor in the reduction of fertility levels is delayed fertility. This research was carried out in Khorramabad, Lorestan Province, Iran.
Methods: This descriptive-analytical study was conducted on 535 married women aged 15-49 years in Khorramabad. The data were collected face-to-face through a cross-sectional survey in 2020 using a researcher-made questionnaire between September and December 2019. This study used the Kaplan-Meier test to determine the childlessness survival time. A logistic parametric model with the gamma shared frailty distributions was employed to analyze its determinants.
Results: The mean of childlessness survival time was 31.76 months, with a median of 24 months. Women in the age group of 15 to 30 years, women with university education, women who married at the age of less than 25 years, and women with a higher sense of socioeconomic insecurity had a longer childlessness survival time (P<0.05).
Conclusion: Childlessness was evaluated as low in Khorramabad. Only 2% of the women remained childless after 10 years of marriage.

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Background and Objective: Paraquat toxicity can damage organisms through mechanisms that are not yet fully understood. Evidence shows that regular exercise and appropriate antioxidant supplements can help reduce the complications caused by paraquat toxicity. This study aimed to evaluate the effect of aerobic exercise training, along with piperine supplement, on the liver levels of tumor necrosis factor-alpha (TNF-a) and interleukin-10 (IL-10) in Wistar rats induced with paraquat.
Methods: In this experimental study, 40 adult Wistar rats were randomly placed into 5 groups of 8, including 1) sham, 2) negative control-paraquat, 3) paraquat + training, 4) paraquat + training + piperine, and 5) paraquat + piperine. Aerobic training included 7 weeks of walking on a treadmill (5 sessions per week for 30-40 min per session, at a speed of 10-18 m/min). Paraquat was administered to the rats by intraperitoneal injection at a dose of 5 mg/kg of body weight. The piperine supplement was daily gavaged at a dose of 10 mg/kg of body weight. The concentration of TNF-a and IL-10 was measured in the liver tissue.
Results: A significant increase in IL-10 and a decrease in TNF-a concentrations were observed between the paraquat-negative control groups compared to the sham, paraquat + exercise, paraquat + piperine, and paraquat + exercise + piperine groups (P<0.05). There was a significant difference between the mean concentrations of TNF-a in the liver tissue between the two negative control groups - paraquat with paraquat + piperine supplement (P<0.05), paraquat + exercise + piperine (P<0.05), paraquat + exercise (P<0.05), and sham (P<0.05). There was a significant difference in concentrations of IL-10 in the liver tissue between the two negative control groups - paraquat with paraquat + piperine supplement, paraquat + exercise + piperine, paraquat + exercise), and sham (P<0.05).
Conclusion: The concentration of TNF-a and IL-10 in male rats induced with paraquat were significantly decreased and increased, respectively, compared to paraquat + piperine supplement, paraquat + exercise + piperine, paraquat + exercise, and sham groups. Therefore, it seems that performing aerobic exercise, along with piperine supplementation, can be a proper way to reduce the inflammation caused by paraquat.

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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.

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Stroke survivors often experience various motor complications, and sustained treatment is crucial for their recovery. Game-based telerehabilitation interventions appear to facilitate motor improvement in these patients by ensuring sustained treatment. Therefore, the present study aimed to evaluate game-based telerehabilitation on motor function in stroke patients. This narrative review involved a comprehensive search of the PubMed database up to August 2024, using the keywords "Game," "Games," "Serious games," "Telerehabilitation," and "Stroke," both individually and in combination. Out of 118 articles initially identified, duplicates and articles published before 2018 were excluded. Ultimately, 9 articles meeting the inclusion and exclusion criteria were selected for review. The full text of these English articles was then analyzed and compared in terms of study design and intervention outcomes on improving motor function. Of the 9 studies reviewed, 6 focused on improving upper extremity motor function, 2 on improving lower extremity motor function, and 1 on improving motor function in both upper and lower extremities. All 9 studies reported positive results regarding improving upper and lower extremity motor function through game-based telerehabilitation. However, most studies had small and varied sample sizes, and there was no consensus on the optimal frequency or duration of game use. Furthermore, the technology employed in these games was found to be expensive for less developed countries. Given the positive outcomes of this approach for stroke patients, developing affordable, localized games and integrating them into national rehabilitation programs could significantly benefit both patients and healthcare systems.

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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.