The terrible triad of the elbow consists of an elbow joint dislocation (ulnohumeroradial and radiocapitellar), a fracture of the radial head or neck, and a fracture of the coronoid process. Since these injuries are highly prone to persistent pain, poor painful functional outcomes, and common complications—including instability, elbow stiffness, and osteoarthritis—their treatment is predominantly surgical to achieve stability and initiate early mobilization. However, non-surgical treatment may occasionally be appropriate in carefully selected, compliant patients under close clinical and radiographic surveillance. The present study reports a case of an unstable terrible triad of the elbow that was initially a candidate for surgery. However, due to the patient's cardiomyopathy, following initial reduction in the operating room, a long arm splint was applied at 100 degrees of flexion because of instability and re-dislocation. The patient was prescribed Indomethacin 25 mg 2–3 times daily, along with Omeprazole. On the first postoperative day, finger movements and isometric contractions of the forearm and arm muscles were instructed. The splint was removed after 2 weeks, and a splint at 90 degrees of elbow flexion stopping proximal to the wrist was applied until the end of the 6th week. Upon observing satisfactory radiographs at a 45 degrees angle, active motion was permitted from full flexion to 45 degrees of flexion. After 4 weeks, following acceptable radiographs at 30 degrees of flexion, motion was allowed from full flexion to 30 degrees of flexion. At the 6-month follow-up, the patient was satisfied and demonstrated healing of the radial neck fracture. The coronoid process fracture healed via fibrous union but remained asymptomatic. There was no evidence of elbow osteoarthritis, ulnar neuropathy, or heterotopic ossification. The patient exhibited a 20 degrees elbow flexion contracture.
Background and Objective: Obesity is a major public health concern worldwide. Evidence suggests that fatigue can lead to significant alterations in mechanical components among obese individuals compared to their healthy counterparts. The present study aimed to determine the effect of fatigue on the mechanical values of impulse and center of pressure (COP) in obese individuals with pronated feet during a landing maneuver. Methods: This quasi-experimental study was conducted in Ardabil Province, Iran, on 16 male students with healthy feet and normal body mass indices (BMIs<25) and 15 obese male students (BMI>30) with pronated feet. During the test, mechanical variables were recorded for both groups before and after implementing the fatigue protocol, utilizing a force plate (sampling rate: 1000 Hz) during a landing maneuver. Results: In the between-group comparison, the mechanical impulse values along the anteroposterior axis were significantly higher in the “healthy feet with normal BMIs” group (34.69±17.9) compared to the “obese with pronated feet” group (9.41±2.07) (P<0.05). In the within-group comparison of “obese students with pronated feet”, no statistically significant differences were found before and after the fatigue protocol during a landing maneuver for the mechanical variables of vertical impulse, anteroposterior impulse, mediolateral impulse, mediolateral COP, and anteroposterior COP. Conclusion: In the mechanical components of impulse, the “obese with pronated feet” group exhibited a statistically significant decrease compared to the “healthy feet with normal BMIs” group during a landing maneuver; however, the fatigue protocol did not alter the impulse values.
Background and Objective: Amiodarone is an effective antiarrhythmic drug used for cardiac arrhythmias. Due to the presence of iodine in its structure, it tends to accumulate in lipophilic tissues, including the lungs, leading to lung injury and other major adverse effects. The present study aimed to determine the protective effects of vitamin E and the aqueous extract of Thymus vulgaris (T. vulgaris) leaves against amiodarone-induced cytotoxicity in non-cancerous human lung fibroblast (HLF) and human lung cancer (A549) cell lines. Methods: This descriptive-analytical study was conducted on HLF and A549 cell lines obtained from the Pasteur Institute of Iran in the cell culture laboratory at the Faculty of Pharmacy, Mazandaran University of Medical Sciences. The grouping for non-cancerous HLF and A549 cell lines included a negative control group, a positive control group (amiodarone at its inhibitory concentration [IC50]), treatment groups receiving T. vulgaris and vitamin E at concentrations of 10, 20, and 50 μM, and single-treatment groups receiving T. vulgaris and vitamin E at 50 μM. All experiments were performed in triplicate with an initial cell density of 104 cells per well. To evaluate amiodarone-induced cytotoxicity (5.6 μM), methylthiazolyldiphenyl-tetrazolium bromide (MTT) (48 h), reactive oxygen species (ROS) (6 h), and lipid peroxidation (LPO) (48 h) assays were performed. Results: The addition of amiodarone to both A549 and non-cancerous HLF cells culminated in a significant decrease in cell viability percentage in the MTT assay (at a concentration of 50 µM T. vulgaris and vitamin E in the normal cell line, and 20 µM T. vulgaris and vitamin E in the A549 cell line). Moreover, it led to a significant increase in ROS (at concentrations of 20 and 50 µM T. vulgaris and vitamin E in the normal cell line, and 20 µM T. vulgaris and vitamin E in the A549 cell line), as well as malondialdehyde (MDA) levels in the LPO assay (at concentrations of 20 and 50 µM T. vulgaris and vitamin E in the normal cell line, and 20 µM T. vulgaris and vitamin E in the A549 cell line) (P<0.05). Furthermore, adding a combination of vitamin E and extract of T. vulgaris leaves in amiodarone-intoxicated non-cancerous HLF cells led to a significant increase in cell viability against IC50 toxicity, alongside a significant reduction in ROS and MDA levels (P<0.05). Conclusion: The addition of amiodarone to both A549 and non-cancerous HLF cell lines induces cytotoxicity in these cell lines. Concomitant treatment with vitamin E and extract of T. vulgaris leaves in amiodarone-treated cells culminates in a reduction in oxidative damage and an increase in cell viability in non-cancerous HLF cells.
Background and Objective: Diabetic nephropathy initiates with chronic hyperglycemia and the manifestation of significant alterations in renal indices. This stage represents a critical turning point between the onset of early diabetic nephropathy symptoms and renal damages. The present study aimed to evaluate the effects of the aqueous extract of Launaea acanthodes aerial parts on antioxidant and renal indices in alloxan-induced diabetic male rats. Methods: In this experimental study, 32 adult male Wistar rats were randomly divided into four groups of eight animals each: A control group, a diabetic control group, and two treatment groups receiving the aqueous extract of Launaea acanthodes stems and leaves (100 and 300 mg/kg BW). Following a 16-hour fasting period, an experimental model of diabetes was induced in the diabetic control and treatment groups via a single intraperitoneal injection of alloxan monohydrate (120 mg/kg BW). Following the confirmation of experimental diabetes, the alloxan injection process was maintained every other day for 30 days. Thirty days after the induction of diabetes, the treatment process was performed intraperitoneally every other day using Launaea acanthodes extracts at concentrations of 100 and 300 mg/kg. Twelve hours after the completion of the 30th day, the animals were anesthetized, blood samples were collected via the left ventricle, and the kidney tissue was then excised. Blood plasma was separated from the blood samples, and blood urea nitrogen (BUN), urea, uric acid, and creatinine levels were measured. The Bradford assay was utilized to determine the total protein concentration. Glutathione S-transferase (GST) was assayed using a ZellBio kit, and catalase (CAT) activity was evaluated based on the decomposition of hydrogen peroxide. Additionally, superoxide dismutase (SOD) activity and malondialdehyde (MDA) levels were assessed. Results: A significant increase in fasting blood glucose (FBG) and MDA levels, alongside a significant decrease in antioxidant enzymes, including SOD, GST, and CAT, was observed in the diabetic control group compared to the healthy control group (P<0.05). Dose-dependent administration of the aqueous extract at concentrations of 100 and 300 mg/kg BW led to a significant reduction in FBG and MDA levels, as well as a significant increase in antioxidant enzymes, including SOD, GST, and CAT, compared to the diabetic control group (P<0.05). Biochemical evaluations indicated a significant increase in blood urea, BUN, uric acid, and creatinine in the diabetic control group compared to the healthy control group (P<0.05). Dose-dependent administration of the extract at concentrations of 100 and 300 mg/kg BW resulted in a significant decrease in blood urea, BUN, uric acid, and creatinine (P<0.05). Conclusion: It appears that the aqueous extract of Launaea acanthodes aerial parts dose-dependently attenuates hyperglycemia, oxidative stress, and renal indicators in alloxan-induced diabetic rats.
Background and Objective: Impairment in nitric oxide (NO) production can culminate in pathological conditions, such as pulmonary hypertension, acute respiratory distress syndrome (ARDS), and chronic obstructive pulmonary disease (COPD). The present study aimed to investigate the effects of L-arginine and L-nitro-arginine methyl ester (L-NAME) on the diameter and number of pulmonary alveoli in female rats. Methods: In this experimental study, 32 female Sprague-Dawley rats, aged 8 weeks and weighing 200–250 g, were randomly divided into four groups of eight. Group 1 received normal saline (2 ml/kg body weight [BW]), Group 2 received L-arginine (200 mg/kg BW), Group 3 received L-NAME (20 mg/kg BW), and Group 4 received a combination of L-arginine (200 mg/kg BW) and L-NAME (20 mg/kg BW) via intraperitoneal injection for two weeks. The animals were then anesthetized, and their lungs were excised. After fixation and tissue processing, histological sections were stained with hematoxylin and eosin (H&E) to evaluate the resulting changes. To obtain quantitative data regarding the diameter and number of alveoli, ImageTool III software was utilized. Results: Injection of L-NAME and L-Arginine led to a non-significant decrease in the mean diameter of pulmonary alveoli. L-Arginine exerted the greatest effect and L-NAME had the least effect on the number of pulmonary alveoli; however, these changes were not statistically significant. Conclusion: Injection of L-Arginine and L-NAME had no significant effect on the diameter and number of pulmonary alveoli in female rats.
Background and Objective: Pronated foot is one of the lower extremity deformities, and obesity is considered a major dilemma in modern society. The present study aimed to determine the interactive effect of overweight and pronated foot on the frequency spectrum of lower extremity muscle activity in men during running. Methods: This quasi-experimental study was conducted on 40 male students aged 21–35 years, who were assigned non-randomly into four groups of 10: Normal weight with normal foot, obese with pronated foot, obese with normal foot, and normal weight with pronated foot. The activity of selected muscles, including the tibialis anterior, medial gastrocnemius, vastus lateralis, vastus medialis, rectus femoris, biceps femoris, semitendinosus, and gluteus medius, was recorded during running using electromyography (EMG). Results: The frequency spectrum of the electrical activity of the biceps femoris muscle was significantly lower in the “obese with normal foot” group compared to the “normal weight with pronated foot” group (P<0.05). The interactive effect of fatigue and group was not statistically significant. Conclusion: In the “obese with pronated foot” group, the observed increase in muscle activity may reflect the neuromuscular system's attempt to manage biomechanical loads. Furthermore, individual differences in movement patterns, fitness levels, and compensatory strategies may contribute significantly to variations in muscle activity.
Background and Objective: The tilt table test is a diagnostic modality used to evaluate patients presenting with altered levels of consciousness (ALOC) or orthostatic symptoms. The autonomic nervous system's response to postural changes induces alterations in sympathovagal tone, subsequently altering various electrocardiographic (ECG) parameters. The index of cardio-electrophysiological balance (iCEB) is calculated based on the ratio of the QT interval to the QRS duration, serving as a non-invasive measure of the cardiac impulse wavelength. The present study aimed to evaluate changes in the iCEB during the tilt table test in patients with ALOC. Methods: This case-control study was conducted using a convenience sampling method on the medical records of 40 patients selected from among 390 patients with ALOC who visited the tilt table Laboratory at Ayatollah Taleghani Educational and Medical Center in Gorgan, Golestan Province, Iran. The participants were divided into two groups of 20 (10 males and 10 females per group). Based on medical records, 20 patients with a positive tilt table result were initially selected, followed by the random selection of 20 patients with a negative tilt table result, who were age- and sex-matched with the first group. The data related to patients’ ECG, blood pressure, and pulse rate were recorded and compared prior to the test (baseline conditions), during tilt, and during recovery. Results: The mean and standard deviation of iCEB in the positive tilt table group at baseline, tilt, and recovery phases were determined to be 6.04±1.48, 6.18±1.85, and 6.81±1.72, respectively. In the negative tilt table group, these values were 4.67±2.01, 4.46±2.07, and 4.48±2.19, respectively. Between-group comparisons revealed a statistically significant increase in the iCEB among patients with positive tilt table results compared to those with negative tilt table results during the baseline, tilt, and recovery phases (P<0.05). However, the values were not statistically significant for the corrected iCEBc. Conclusion: Baseline values of the iCEB may serve as useful predictors for tilt table test results in patients presenting with ALOC.
Background and Objective: Conventional treatments for primary dysmenorrhea are often associated with adverse effects, including nausea, headache, and dizziness, and may be contraindicated in certain cases. In Iranian traditional medicine texts, fennel is recommended for pain relief and the induction of menstruation; it also exhibits antiemetic and antinauseant effects. Valerian is a traditional Indian medicinal plant that has been utilized as a sedative, antispasmodic, and hypnotic agent. The present study aimed to determine the effects of fennel and valerian herbal medicines on relieving primary dysmenorrhea-induced pain. Methods: This clinical trial was conducted on 120 single girls with primary dysmenorrhea who referred to healthcare centers in Khomein, Iran, in 2019. The subjects were selected via a convenience sampling method and randomly allocated into the control, first intervention, and second intervention groups. The control group received mefenamic acid capsules (250 mg), the first intervention group received fennel capsules (30 mg of sweet fennel essential oil), and the second intervention group received valerian capsules (350 mg of plant root) over two consecutive menstrual cycles. Pain severity was measured using the visual analog scale (VAS) during two consecutive menstrual cycles prior to the intervention and two consecutive menstrual cycles following the initiation of the intervention (a total of four cycles). Results: At the end of the study, the primary dysmenorrhea-induced pain severity significantly decreased in all three studied groups (P<0.05); however, this pain relief was significantly greater in the valerian-receiving group (the first intervention group) compared to the fennel-receiving (the second intervention group) and mefenamic acid-receiving (the control group) (P<0.05). The odds ratio (OR) of experiencing higher pain severity in the first and second intervention groups compared to the control group was determined to be 0.23 (95% CI: 0.07-0.72, P=0.013) and 0.51 (95% CI: 0.28-0.93, P=0.028), respectively. Conclusion: Valerian and fennel herbal medicines can be utilized as effective alternatives with fewer adverse effects compared to mefenamic acid for relieving primary dysmenorrhea-induced pain.
Background and Objective: Morbid obesity is a growing global health concern, affecting more than 400 million individuals worldwide. In cases where dietary interventions, lifestyle modifications, and pharmacotherapy fail, bariatric surgery (such as sleeve gastrectomy [SG] and gastric bypass [GB] surgeries) remains the most effective therapeutic option. In addition to inducing weight loss, these surgical procedures ameliorate comorbidities such as diabetes, hypertension, and fatty liver disease (FLD). The present study aimed to evaluate liver enzyme alterations and non-alcoholic FLD (NAFLD) improvement rates six months following SG and GB surgeries. Methods: This retrospective cohort study was conducted on 120 patients (62.2% female) with morbid obesity (mean age = 35.2±11.13 years) who underwent bariatric surgeries at Falsafi Hospital in Gorgan, Golestan Province, Iran during 2021-23. Patients with a body mass index (BMI) greater than 40 kg/m2, or greater than 35 kg/m2 with underlying comorbidities, were included. Exclusion criteria consisted of excessive alcohol use, a history of hepatic surgery, and early pregnancy post-surgery. Liver enzyme levels (alanine aminotransferase [ALT], aspartate aminotransferase [AST], and alkaline phosphatase [ALP]), as well as serum albumin (ALB) levels, were measured at baseline and 6 months post-surgery. Results: A total of 95 patients presented with FLD. After 6 months, the fatty liver grade decreased in 57 patients, increased in 4, and remained unchanged in 34 (P<0.05). Specifically, reductions of 35%, 45%, and 82% were observed in grades I, II, and III, respectively. ALT, AST, and ALP decreased by 6.1 U/L, 12.8 U/L, and 9.58 U/L, respectively (P<0.05). ALB levels showed no statistically significant change. Type 2 diabetes, hypertension, advanced age, or a higher BMI had no significant effect on the reduction of liver enzymes. Conclusion: Bariatric surgery improved FLD and significantly reduced liver enzymes (ALT, AST, and ALP).
Background and Objective: Regular physical activity can improve the function of various body systems and exert significant effects on pulmonary function, inflammation, and vascular growth factors. The present study aimed to determine the effects of eight weeks of aerobic exercise training on pulmonary function, C-reactive protein (CRP), creatine phosphokinase (CPK), and vascular endothelial growth factor (VEGF) in active young females. Methods: This field trial was conducted on 20 active young females aged 19 to 24 years at University of Mohaghegh Ardabili in 2024. The subjects were randomly assigned to two groups of 10, including an intervention group and a control group. The intervention group performed a regular aerobic exercise training program for eight weeks (three sessions per week) at an intensity of 70% of their maximum heart rate (HRmax) for 40 minutes per session, whereas the control group had no specific physical activity. Pulmonary function indices, including forced vital capacity (FVC) and forced expiratory volume in one second (FEV1), as well as CRP, CPK, and VEGF levels, were measured before and after the training period. Results: Following 8 weeks of aerobic exercise training, the intervention group demonstrated a significant increase in FVC (3.11±0.61) and FEV1 (3.10±0.58) compared to the control group (P<0.05), alongside a statistically significant decrease in CRP (1.6±0.61) (P<0.05). However, changes in CPK levels were not significant. Additionally, VEGF (9.74±2.3) significantly increased post-intervention compared to the control group (P<0.05). Between-group comparisons revealed no significant differences at the pre-test stage. Conversely, a statistically significant difference in CRP levels was observed between the groups at the post-test stage (P<0.05). Conclusion: Eight weeks of moderate-intensity aerobic exercise training (at 70% of HRmax) was effective in improving pulmonary function, reducing CRP, and increasing VEGF in active young females.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
