Journal of Gorgan University of Medical Sciences
Year:2024 | Volume:26 | Issue:2|Papers Count:10

This systematic review aimed to evaluate the effects of various corrective exercises and supportive tools in individuals with genu valgum. To ensure a comprehensive review, a search for original research, review articles, and clinical trials in both Persian and English was conducted using databases such as WOS, SID, ISC, Magiran, Scopus, PubMed, and Google Scholar. The search covered publications during January 2008 to March 2023. A total of 76 relevant articles were selected based on strict inclusion and exclusion criteria, with 22 articles ultimately reviewed and analyzed regarding the effects of various corrective exercises and supportive tools on genu valgum. Findings from one study indicated that aerobic exercises had a significant impact on reducing body mass index (BMI) and the severity of genuvalgum. Other studies reported positive effects of resistance and corrective exercises on improving muscle electrical activity and knee stability. One study demonstrated that the use of orthotic insoles could significantly enhance knee joint support during stair descent. Six studies highlighted the positive effects of using orthoses, wedges, and braces in individuals with genu valgum. Conversely, one study pointed out the negative impact of these tools, citing the reduced limiting angle of the brace, increased applied forces, and, ultimately, greater injury risk. However, findings from three studies overwhelmingly supported the positive effects of using kinesiotape in individuals with genu valgum, providing optimism about the effectiveness of these interventions. In conclusion, our review underscores the promising potential of corrective exercises, particularly resistance exercises with TheraBand, and the combination of these with supportive tools such as insoles for arch support and kinesiotape. These interventions show significant promise in reducing the degree of knee valgus in individuals with genu valgum. This hopeful outlook can inspire healthcare professionals and individuals seeking evidence-based interventions for genu valgum, empowering them with the knowledge to make informed decisions about their care.

Background and Objective: Neural, hormonal, and mechanical factors regulate the expression of fast-twitch isoforms in developing and mature muscle fibers. The transcriptional mechanisms responsible for regulating the gene expression of myosin heavy chain types are not well understood. This study aimed to determine the effect of a single session of intense resistance exercise with glutamine supplementation on the relative expression of the alpha and IIX isoforms of the myosin heavy chain gene in male rats. Methods: This experimental study was conducted on 30 adult male Wistar rats divided into three groups: control, intense resistance exercise (first experimental group), and fierce resistance exercise combined with glutamine supplementation (second experimental group). The exercise groups participated in a single session of resistance climbing on an inclined plane with 4 sets of 5 repetitions, 30 seconds of rest between repetitions, and 2 minutes of rest between sets. Glutamine supplement powder was dissolved in 100 ml of distilled water at a dose of 0. 5 grams per kilogram of body weight and administered daily via gavage for 5 days. The expression of alpha and IIX isoforms of the myosin heavy chain gene was examined in the extensor digitorum longus muscle tissue. Results: The relative expression of the alpha myosin heavy chain gene in the fast-twitch muscle fibers increased significantly in the first experimental group (1. 93±0. 298) and the second experimental group (1. 65±0. 195) compared to the control group (P<0. 05). The relative expression of the IIX motor unit gene in the fast-twitch muscle fibers also increased significantly in the first experimental group (1. 42±0. 239) and the second experimental group (1. 26±0. 190) compared to the control group (P<0. 05). The increase in the relative expression of the alpha myosin heavy chain gene in the first experimental group compared to the second experimental group was statistically significant (P<0. 05). However, the increase in the relative expression of the IIX motor unit gene in the first experimental group compared to the second experimental group was not statistically significant. Conclusion: Our study concludes that a single session of intense resistance exercise, with or without glutamine supplementation, significantly increases the relative expression of the alpha myosin heavy chain gene and the IIX motor unit gene in the fast-twitch muscle fibers of the extensor digitorum longus muscle in adult male rats. These findings provide valuable insights into the molecular

Background and Objective: Ensuring suitable access to hemodialysis, which provides high-quality dialysis over an extended period, is a significant challenge for patients with End-Stage Renal Disease (ESRD). One crucial aspect of this is maintaining the performance of hemodialysis catheters. Our study, which aimed to evaluate the one-year performance of long-term catheters in chronic hemodialysis patients in Golestan Province, is a critical step toward improving patient care in this population. Methods: This descriptive-analytical study was conducted on 99 patients (34 men and 65 women) with ESRD who were candidates for starting or continuing dialysis with a catheter in the educational and therapeutic centers of Golestan Province, Iran during 2021-22. Transjugular catheters were placed for the patients, and after one year, variables such as age, gender, history of diabetes, history of hypertension, catheter placement site (right or left jugular), and antiplatelet medication use were evaluated concerning the performance of long-term catheters in providing adequate flow for hemodialysis. Results: In 91 patients (91. 9%), the one-year catheter performance was assessed as satisfactory. The age of 61. 6% of the patients were over 60 years old. Sixty-nine patients (69. 7%) had a history of hypertension, and 58 patients (58. 6%) had a history of diabetes. Fifty-seven patients (57. 6%) received antiplatelet medication. The catheters were placed on the right side in 82 patients (82. 8%). Catheter performance in patients taking antiplatelet medication was non-significantly higher than in those not taking antiplatelet medicines. Conclusion: The performance of long-term catheters in chronic hemodialysis patients with ESRD showed no significant correlation with age, gender, diabetes, hypertension, antiplatelet medication use, or the side of the jugular vein where the catheter was placed.

Background and Objective: The psychological experience of mental pain can lead to distress similar to that caused by actual injury or trauma. As such, it poses a life-threatening consequence for chronic patients, although it is rarely assessed and treated in clinical settings. One of the diseases associated with high levels of physical and mental pain is the rare disorder neurofibromatosis. This study aimed to evaluate mental pain in patients with neurofibromatosis and its association with disease severity. Methods: This descriptive-analytical study was conducted on 207 patients with neurofibromatosis who were members of the Iranian Neurofibromatosis Support Association during 2023. Data collection tools included a demographic and clinical information registration form and the Orbach and Mikulincer Mental Pain Scale (OMMP), which comprises 44 items and 6 subscales, with a scoring range from 44 to 220. Results: The total mental pain score was 121. 15±42. 41, with a range of 44 to 206. The total mental pain scores for men and women were 123. 67±38. 98 and 120. 31±43. 58, respectively. The "confusion" subscale had the highest average score, while the "fear of loneliness" subscale had the lowest average score. There was a statistically significant association between the total mental pain score and its subscales with the severity of the disease and the patient's educational level (P<0. 05). Conclusion: The mental pain scores of patients with neurofibromatosis were evaluated to be relatively unfavorable.

Background and Objective: Oral and dental health are crucial for nutrition intake, speech, and facial aesthetics. They also significantly influence individuals' physical, social, and psychological activities. This study aimed to determine the relationship between the Dental Caries Index (DMFT) and oral health-related quality of life. Methods: This descriptive-analytical study was conducted on 61 patients (29 men and 32 women) aged 20-50 years who visited the Gorgan Dental School Clinic, Iran during 2019. The DMFT index, encompassing Decay (D), Missing (M), and Filled (F) teeth, was calculated. Quality of life was assessed using the 36-item DIDL (Dental Impact on Daily Living) questionnaire, which covers five domains: dental appearance and aesthetics, oral comfort, overall oral and dental function, eating limitations, and dental and jaw pain. Scores were categorized into three groups: dissatisfied (below 0), moderately satisfied (0 to 7), and satisfied (above 7). Results: The mean score for oral health-related quality of life was 5. 14±0. 229, indicating a relative level of satisfaction. Pearson's correlation coefficient between DMFT and oral health-related quality of life was-0. 358, suggesting a significant inverse relationship between DMFT and quality of life (P<0. 05). The mean DMFT score ranged from 0 to 28, with a mean of 9. 36, and the most frequent scores were 7, 11, and 13, each accounting for 11. 5% of the sample. The mean decay (D) score was 3. 44, the mean missing (M) score was 1. 98, and the mean filled (F) score was 3. 93, with ranges of 0-12, 0-19, and 0-13, respectively. Conclusion: The results of this study indicate an inverse impact of the Dental Caries Index on patients' quality of life. Oral health-related quality of life is a multifaceted construct that affects various aspects such as appearance, oral comfort, and eating limitations, which are critical components of overall quality of life and satisfaction.

Background and Objective: Weight regain following bariatric surgery is a significant challenge for this obesity treatment method. This study aimed to identify factors associated with weight regain after bariatric surgeries in obese patients in Gorgan, Iran. Methods: This longitudinal study included 143 obese individuals (125 women and 18 men) with a mean age of 43. 13±9. 83 years who underwent bariatric surgery in Gorgan, Iran during 2013-19. Participants were invited to join the study via phone calls. Research variables (type of surgery, blood group, pre-surgery weight, and body mass index [BMI]) were extracted from patient records, and their current weight and waist circumference were measured and recorded. Weight regain was determined based on one of three different criteria: (1) regaining more than 25% of the maximum weight lost post-surgery, (2) regaining more than 10 kg from the minimum weight post-surgery, or (3) an increase of more than 5 BMI units from the lowest BMI post-surgery. Results: Overall, 33% of individuals experienced weight regain, with 26. 6% according to the first definition, 29. 4% according to the second definition, and 18. 2% according to the third definition. Men had a higher rate of weight regain (P<0. 05). Additionally, 93. 6% (44 cases) of those with weight regain had abdominal obesity. On average, 79. 7% of participants who were 48 months post-bariatric surgery experienced some degree of weight regain. Individuals with a pre-surgery BMI of 50 or higher had a 2. 69 times greater chance of weight regain compared to those with BMI lower 50 (P<0. 05). The mean weight loss after surgery was significantly higher in individuals who experienced weight regain than those who did not (P<0. 05). There was no significant statistical association between weight regain and the type of surgery, age, education level, marital status, or blood group. Conclusion: Weight regain over time is a reality after bariatric surgery, indicating that this method is not a definitive cure for obesity. Therefore, long-term follow-up for weight control is crucial, especially for individuals with a pre-surgery BMI of 50 or higher or those who experienced significant weight loss post-surgery.

Background and Objective: Opium use is one of the most common problems that impose significant social, psychological, and economic burdens on societies. Understanding the factors involved in the treatment of opium use is essential. This study aimed to evaluate inhibitory response and impulsivity in opium users. Methods: This descriptive-analytical study was conducted on 170 opium users (139 men and 31 women) who visited the Methadone Maintenance Treatment Center in Gorgan, Iran during 2022, selected through convenience sampling. The Stop Signal Task (SST) was used to assess participants' inhibitory response, and the Barratt Impulsiveness Scale (BIS) was used to measure impulsivity levels. Results: The average overall impulsivity score was 67. 8±11. 85. The average correct responses were 45. 09±5. 67, incorrect responses were 4. 51±3. 95, and delays were 0. 96±2. 32. The mean response time to each stimulus was 1290±512. 83 milliseconds. There was a statistically significant correlation between impulsivity dimensions and age, correct responses and education level, and response time for inhibitory control with age and education level (P<0. 05). There was no statistically significant correlation between the various dimensions of inhibitory response and impulsivity (cognitive impulsivity, non-planning impulsivity, and motor impulsivity) and overall impulsivity. Conclusion: Opium users are generally impulsive. Additionally, younger individuals and those with lower education levels are more impulsive compared to others.

Background and Objective: Dermatophytosis is a significant skin disease in humans and animals, with increasing resistance to conventional treatments. This study aimed to determine the antifungal activity of petroleum ether, dichloromethane, ethyl acetate, ethanol, and hydroethanol extracts from the aerial parts of Artemisia khorassanica, Artemisia scoparia, and Artemisia vulgaris against common dermatophytic fungi, including Trichophyton rubrum, Trichophyton verrucosum, Epidermophyton floccosum, and Microsporum canis. Methods: This descriptive study examined the antifungal activity of various extracts from the aerial parts of Artemisia khorassanica, Artemisia scoparia, and Artemisia vulgaris against fungal isolates of Trichophyton rubrum, Trichophyton verrucosum, Microsporum canis, and Epidermophyton floccosum. The aerial parts of the three Artemisia species were extracted using five solvents: petroleum ether, dichloromethane, ethyl acetate, ethanol, and 50% hydroethanol. The extracts were screened for antidermatophytic effects against the fungi mentioned above, and the minimum inhibitory concentration (MIC) was determined using the agar dilution method. The most active extracts underwent preliminary phytochemical testing. Results: In the initial screening, Microsporum canis and Trichophyton verrucosum showed the highest sensitivity (86. 66%) and resistance (100%) to the tested extracts, respectively. Extracts from Artemisia scoparia exhibited the broadest range of activity. The most effective extracts, with an MIC of 78. 12 µg/ml, were also from this plant. Hydroethanol extracts from all plant species demonstrated the least antidermatophytic activity. Preliminary phytochemical studies revealed the presence of terpenoids in all petroleum ether and dichloromethane extracts of the plant species. Conclusion: Some lipophilic compounds, particularly in the petroleum ether and dichloromethane extracts of Artemisia scoparia, exhibit significant in vitro antidermatophytic activity.

Background and Objective: Periodontitis and rheumatoid arthritis are two chronic inflammatory diseases that are interrelated. Given the similarities between these conditions, the medications used by patients with rheumatoid arthritis (RA) may affect their periodontal indices. This study aimed to evaluate the periodontal index status in patients with RA undergoing immunosuppressive therapy. Methods: This comparative cross-sectional study was conducted on 68 patients with RA in three treatment groups (20 on monotherapy, 24 on dual therapy, and 24 on triple treatment) and 20 healthy individuals with a plaque index (PI) below 35% in Ardabil, Iran during the second half of 2021. The monotherapy group included methotrexate or hydroxychloroquine,the dual therapy group included combinations of methotrexate with hydroxychloroquine, adalimumab, or infliximab,and the triple therapy group included combinations of methotrexate and hydroxychloroquine with adalimumab, etanercept, sulfasalazine, or leflunomide. Periodontal indices, including Plaque Index (PI), Clinical Attachment Loss (CAL), Gingival Index (GI), and Bleeding on Probing (BOP), were assessed. Results: There were no statistically significant differences in periodontal indices among the three treatment groups (monotherapy, dual therapy, and triple therapy). The mean BOP index in the control group was significantly higher compared to the three medication groups (P<0. 05). There were no statistically significant differences in the mean CAL and GI indices between the control group and the medication groups. The median PI in the control group was 29. 6, and in the dual therapy group, it was 42. 3, which was statistically significant (P<0. 05). Conclusion: The use of immunosuppressive drugs did not have a significant effect on the periodontal indices of patients with rheumatoid arthritis.

Renal cavernous hemangioma is a rare benign tumor. This case report describes a 44-year-old male who was incidentally found to have a renal mass during an abdominal and pelvic ultrasound. The patient's abdominal ultrasound revealed a mass, which was further evaluated with a CT scan. The CT findings suggested renal cell carcinoma. Suspecting malignancy, the patient underwent radical nephrectomy. Histopathological and immunohistochemical examinations ultimately diagnosed the mass as a cavernous hemangioma. Despite its benign nature, the patient was followed up with a control ultrasound three months post-surgery. This case is presented due to the significant clinical and radiological resemblance of this tumor to renal carcinomas, highlighting the importance of considering benign tumors in differential diagnoses.