Razi Journal of Medical Sciences
Year:2017 | Volume:24 | Issue:160 |Papers Count:17

Background: Arteriovenous fistula is an important method for hemodialysis and prediction of fistula function and failure rate and access is crucial. This study was performed to determine the association between Doppler ultrasonography findings with function and failure and access rate of fistula. Methods: In this observational comparative cross-sectional study, out of 108 patients requiring fistula who had no appropriate condition, 61 consecutive patients with chronic renal failure under hemodialysis were enrolled and Doppler ultrasonography findings were determined and the association with failure and access rate was assessed. Results: In this study, thrill was present in 96. 7%. The outcome was good in 92. 2%. There was no association between Doppler ultrasonography findings with function and failure and access rate of fistula (p> 0. 05). Conclusion: Finally, according to the obtained results, it may be concluded that Doppler ultrasonography is useful to improve the function, reduce the failure and increase the access rate of fistula.

Background: Atrophy in skeletal muscle plays an important role in disease-related tissue dysfunction such as sarcopenia. The Wnt-signaling pathway has been shown to be critical for skeletal muscle development. Current evidence suggests that exercise trainings may alter hypertrophy-related signaling in skeletal muscle. Therefore, the purpose of this study was investigating the effect of three months aerobic training on Wnt-signaling pathway in skeletal muscle of male rats. Methods: This study was conducted as a two-group experimental design and sixteen 3-month-old male rats were selected and randomly divided into two groups of aerobic training (n=8) and control (n=8). Rats in trained group participated in the aerobic training program for three months (75-80% VO2max). 48 hours after the last training session, the soleus muscle of rats were extracted and β-catenin and glycogen synthase kinase-3β mRNA evaluated by Real Time-PCR. Independent t-test was applied for statistical analysis of the data (p<0. 05). Results: β-catenin gene expression of trained group (1. 11 0. 17) was not significantly lower than the control group (1. 60 0. 99) (30%, p=0. 154). However, glycogen synthase kinase-3β gene expression of trained group (10. 36 3. 51) was significantly higher than the control group (1. 99 1. 2) (420%, p=0. 001). Conclusion: In general, it seems that a three months aerobic training was effective in increasing glycogen synthase kinase-3β gene expression in skeletal muscle. This may be associated with an increased risk of muscle atrophy. However, more researches are needed to identify the effects of different exercise trainings on Wnt-signaling pathway.

Background: The diaphragm is the main respiratory muscle; the diaphragm can rupture in the field of blunt trauma, penetrating trauma or occur following medical procedures. Approximately 0. 8 to 1. 6% of patients with blunt trauma are suspected to have a rupture of the diaphragm. As diaphragmatic rupture is a rare clinical condition, so it may be undiagnosed and associated with complications and high mortality and morbidity. Case report: In this study we report a 53-year-old man, with history of blunt trauma five years ago, but during this period, remained undiagnosed. For shortness of breath, he visits physicians frequently and just receives medical treatment during these years. Finally, requested abdominal X-ray showed diaphragmatic rupture and herniation of the left side of the colon into the thoracic area. Conclusion: Having a strong clinical suspicion, taking a thorough history of the patient, performing an accurate physical examination and doing an essential diagnostic procedures should all be considered to help confirm the diagnosis.

MicroRNAs (miRNAs) are severely protected sequences and single stranded structures approximately 18 to 25 nucleotides in length. The crucial role of miRNAs has been previously proved in the regulation of the gene expression in post transcriptional modification events of messenger RNA. The precise mechanism by which miRNAs modulate translational repression of mRNAs is not fully determined. However, two-third of human messenger RNAs might be miRNA targets nearly. MiRNAs involved in the regulation of gene expression and they play fundamental roles in routine cellular functions, such as cell growth and development, proliferation, differentiation and apoptosis. In addition, increasing evidence has suggested that miRNAs play an essential role in the generation, regulation and homeostasis of immune responses. Several studies in malignancies, infectious and autoimmune diseases, have shown changes in the expression level of miRNAs in cells and tissues and also their direct and indirect associations with diseases are shown. MiRNAs not only exist intracellularly, but also are found in body fluids in combination with lipoproteins or enclosed in the packaging of the bilayer membrane, which are called exosomes. Biological body fluids consist of different samples with specific features, including serum (plasma), saliva, urine, cerebrospinal fluid, tear, semen, Pleural fluid, Peritoneal Fluid, Broncho alveolar lavage (BAL), amniotic fluid, as well as milk (Colostrum). Despite the presence of abundant ribonuclease in body fluids such as serum and urine, circulating miRNAs are stable and easy to be quantitatively measured. The variation in the expression of circulating miRNAs in the biological fluids of patients has enhanced the possibility that miRNAs may serve as novel and accessible diagnostic and prognostic biomarkers. However, the biological function and secretory mechanisms, as well as the meaning of this variation in the expression of miRNAs, remain largely uncertain. Recently, study of circulating miRNAs has opened new window in research to find novel, safe and noninvasive biomarkers in medical science. The potential of circulating miRNAs as biomarkers of disease has mainly been demonstrated for various types of malignancies and autoimmune disease. Newly, however, attention has focused on the use of circulating miRNAs as biomarkers infectious diseases such as human tuberculosis viral hepatitis. The purpose of present review is to analyze and describe the expression of circulating miRNAs in biological fluids. Therefore, we represent the recent studies which are conducted in this field to identify and introduce effective biomarkers for the diagnosis and monitoring treatment in different diseases.

Sandhoff is a rare genetic disease with autosomal recessive inheritance, caused by deficiency in hexosaminidase B enzyme. Symptoms usually begin 6 months after birthday and include developmental delay, visual impairment, seizures, and cherry red spots in the eyes. In this report we present a patient with Sandhoff disease which is confirmed by enzyme assay and molecular methods.

Background: Several treatments have been proposed to control Multiple Sclerosis (MS). Fingolimod is the first oral medication for the disease that was approval by Food and Drug Administration American (FDA) since 2010 and is produced in Iran from October 2013. The aim of this study was evaluation of the effect of fingolimod on the number of brain plaque in multiple sclerosis patients before and after treatment at Magnetic Resonance Imaging (MRI). Methods: This study was analytical and the brain plaques of 64 patients with MS was determined with MRI at the beginning and end of the study (after 12 months of using fingolimod). The software of SPSS 22 was used for statistical analysis. Results: The number of active plaques and number of active plaques in the form of rings on MRI in patients with multiple sclerosis significantly increased after treatment (p<0. 05). But there was no statically difference between the number of active plaques in the form of nodule on MRI in patients with multiple sclerosis befor and after treatment (p>0. 05). Conclusion: Consumption of once-daily fingolimod 0. 5 mg after 12 months can not prevent from the rise of active plaques on MRI in MS patients.

Background: Mental disorders are on the rise which disrupt health status. Depression and loss of self-esteem are the most important problems which will lead to chronic diseases. One of the steps affecting mental health is military service. The aim of this study was to evaluate depression and self-esteem during training troops and their relation with people's lifestyle. Methods: In This semi experimental study 246 soldiers in 2016, according to inclusion criteria were selected from an army barrack. After obtaining informed consent depression and self-esteem and other indices were measured. After 8 weeks, repeated assessments of depression and self-esteem was performed, and the connections with lifestyle was determined by linear regression. Values less than 0. 05 were considered significant. Results: The mean age was 24. 15± 1. 54 years. The degree of depression and self-esteem were 2. 72 and 4. 33 that changed to 2. 24 and 5. 58, respectively. A high diversity of food reduces depression. Weight loss during the period of soldiers on changes in depression and selfesteem was effective and statistically significant. Conclusion: During military training period depression and self-esteem chenged. High dietary diversity and good economic status are protective factors against these changes. Further studies are recommended to determine these relationships.

Background: Patient informed choice improves medical services through creating competition among healthcare providers. Understanding patients’ expectations helps providers meet patients’ needs accordingly. This study aimed to determine factors affecting patient choice of a specialist physician in Tehran, Iran. Methods: A valid and reliable questionnaire based on 10P marketing mix model was used for conducting such a cross-sectional descriptive study. Cluster sampling method was used to recruit 400 patients. Data were analyzed using SPSS software. Results: Factors related to the characteristics of patient and physician and contextual factors influence patient choice. The most important factors in choosing a specialist physician were the package of services, process of providing the services, product (type of service required) and promotion. Conclusion: Quality is an important factor in choosing a medical consultant. Knowledge of factors affecting patient choice of a specialist physician can be used in marketing strategies by physicians. Understanding patients’ preferences and expectations leads to quality improvement of healthcare care services.

Background: Thalassemia is a hereditary anemia caused by abnormal hemoglobin chain formation. Treatment is through blood transfusion, which improves the symptoms. However, blood transfusion has complications e. g transmission of infection such as Parvovirus B19. The aim of this study was to investigate the incidence of Parvovirus B19 infection in thalassemia major patients in Kurdistan province. Methods: In this descriptive study 106 thalassemia patients referred to hospitals in Kurdistan province were randomly selected in 2016. For each patient a questionnaire containing demographic information including age, sex, blood transfusion intervals and duration of blood transfusion were collected. For IgM and IgG antibodies, Euroimmun ELISA kit was used. After the tests, obtained data were analyzed using Pearson statistical test. Results: Prevalence of IgM and IgG antibodies in patients with thalassemia were 3. 7% and 17. 9%, respectively. The correlation between IgG and IgM antibody titer and blood transfusion interval was not significant (p=0. 377, p=0. 254). The correlation between IgG and IgM antibody titer and gender was not significant (p= 0. 61 and p= 0. 961, respectively). Conclusion: Regarding the prevalence of 3. 7% for IgM antibody, screening of donated blood for Parvovirus B19 is necessary in patients with hematological disorders in Kurdistan province.

Background: Previous studies evaluating the association between ApaI, FokI, TaqI, and BsmI polymorphisms of vitamin D receptor gene (VDR) and risk of coronary artery disease (CAD) have produced inconsistent results. The present meta-analysis of eligible studies was conducted to reveal whether this polymorphism plays a role in susceptibility to CAD. Methods: Literature search of Medline and EMBASE databases were conducted to identify all eligible studies. Odd ratios (OR) and their corresponding 95% confidence intervals (CIs) were calculated to assess the strength of association in the dominant model, recessive model, allelic model, homozygotes contrast, and heterozygote contrast. Results: a total of nine case-control studies with 5259CAD cases and 1981 healthy controls were included in this meta-analysis. Overall, we found no significant association between the ApaI, FokI, TaqI, and BsmI polymorphisms of vitamin D receptor gene and CAD risk in any genetic model tested (P ˃ 0. 05). Moreover, in subgroup analysis by ethnicity, no significant association was evident between these polymorphisms and susceptibility to CAD in Caucasians and east-Asians in all models. Conclusion: This meta-analysis suggests that ApaI, FokI, TaqI, and BsmI polymorphisms of vitamin D receptor gene might not be associated with susceptibility to CAD. Further studies are needed to confirm our results.

Background: Inflammation is the body’ s response to various diseases that also happens after strenuous exercise. Previous studies showed significant effect of fish oil on reducing inflammation in patients but its effect on exercise inflammation and muscular performance is not well understood. Therefore, the aim of this study was to investigate the effect of 4-weeks fish oil supplementation on inflammatory mediators and muscular performance in response to exhaustive exercise. Methods: For this purpose, 16 healthy men (age: 26. 90± 2. 64 yrs, weight: 78. 33± 10. 42 kg, height: 175. 80± 4. 89 cm, body fat percent: 18. 40± 5. 46%) voluntarily participated and were assigned in fish oil (FO=9) and corn oil (CO=7) groups and consumed 6 gr/day supplements for 4 weeks. Levels of TNF-α , IL-10 and salivary cortisol were investigated using ELISA method. In addition, MVC of the tibilias anterior muscle was also assessed. Blood and saliva samples and MVC assessments were performed before and after exercise both in pre-and post-supplementation periods. Results: Our results showed significant decrease in baseline values of TNF-α and IL-10 and increase in baseline values of MVC of FO group after supplementation (P<0. 05). In addition, significant differences were observed between IL-10 (F=9. 17, P=0. 017) and MVC (F=4. 79, P=0. 046) changes of participants after supplementation. However, there wasn’ t significant differences in salivary cortisol values after supplementation or exercise (P>0. 05). Conclusion: Our results showed significant effect of FO supplementation on reducing inflammation either before or after exercise that can lead to increase in muscular performance. However, its exact molecular pathways need more investigation.

Transdermal drug delivery system is a non-invasive and an efficient method that provides sustained release and delivers therapeutics to target site. This system can improve the therapeutic efficacy and safety of the drugs, keep the plasma level of the drug constant, prevent the hepatic first pass metabolism and is convenient and pain-free self-administration for patients. Despite the many advantages of this system, the stratum corneum is the main obstacle to penetration through the skin. A series of researches are taken in order to overcome stratum corneum to improve drug penetration. With the development of nanotechnology, using nanovesicles system such as ethosomes has been considered recently. Ethosomes are the ethanolic phospholipid nanocarriers which are mainly employed for transdermal drug delivery. These soft and flexible vesicles can transport drugs to the deep layers of the skin or systemic circulation. The presence of ethanol in ethosomes causes increase in the fluidity of cell membrane lipids and enhances skin permeation of ethosomes. Ethosomes have a lot of advantages including improvement of drug efficiency, decreasing the cytotoxicity of encapsulated drug in the nanovesicle, increasing patient compliance, reducing the cost of treatment and non toxicity of vesicle. In this review, we have tried to describe all aspects of ethosomes including structure, and the main properties of ethosomes, advantages and disadvantages, methods of preparation, mechanism of permeation, and ethosomes function. Also its various features and roles in drug delivery, skin penetration performance of ethosomes are reviewed.