Tehran University Medical Journal
Year:2018 | Volume:76 | Issue:3 |Papers Count:13

Depression is the psychological disorder which caused by chronic stress and extensivecommunication network between the gastrointestinal system via the “ gut– brainmicrobiotaaxis” . Depression can systematically activate/deactivate many genes andsignaling molecules involved in the pathogenesis of the gastrointestinal disease. Whereas, most of the anti-depressant drugs suppress the depression symptoms by alteringthe neurotransmitters activity; studies on probiotics have shown the anti-depressantpotential of them. Nutritional psychiatry is a field of psychiatry that investigates therelationship between dietary patterns and risk of mental disorders. The special type ofprobiotic has been identified to improve a number of diseases, such as diabetes, obesity, gastrointestinal infections, cancers, reduction of allergies and mood disorders such asdepression. There is an evidence about therapeutic effects of probiotics in symptoms ofdepression, but because of the low number of samples, the limitation in use of differentstrains of bacteria and the limited laboratory equipment, it is difficult to make a definitiveview about these results and need to more clinical study to determine the effectivedose of probiotics in the treatment of depression. The articles related to this subjectwere collected from reliable database till the 2017 year, new studies and reviews articleswhich determine the effects of probiotics on the treatment of digestive and neurologicaldiseases. The objective of this review is to study the current clinical researchabout the effects of probiotics in the treatment of symptoms of depression and discussfuture directions in this field. Most of the studies demonstrated probiotics’ ability toimproving mood, change behavior and improve the symptoms of stress and depressionsuch as insomnia by increasing of serotonin and reducing of inflammation; and modulationof emotional behavior with effect on specific cytokines in brain. It has been discoveredthat probiotics have therapeutic effects extend beyond the gut and into the centralnervous system by influence signaling pathways. In conclusion, it seems they havethe potential to be used as a dietary supplement to optimize and enriched the food productsand effective step in the prevention and treatment of various disorders in the nervoussystem instead of chemical drugs.

Background: Breast cancer is a malignant proliferation of epithelial cells that lining theducts or lobules of the breast. Breast cancer is the second common cancer (after lungcancer) in women. Gallic acid, being a polyphenols, has been reported for its antiproliferativeactivity against many cancer cell lines. Objective of the present study is effect ofgallic acid on proliferation and apoptosis of the human breast adenocarcinoma cell linesSKBR3 and normal fibroblasts cells. Methods: This experimental study was performed in cellular and developmental biologyof Shahrekord Islamic Azad University, Iran from April to August 2015. For anticanceractivity, in this study SKBR3 cells and normal fibroblast cells (HU-02) werecultured in Dulbecco's modified eagle's medium, DMEM (Gibco, Life Technologies, Inc., New York, USA) medium with 10% fetal bovine serum, FBS (Gibco, Life Technologies, Inc., New York, USA). The SKBR3 and normal fibroblast cells were treatedin the medium of DMEM medium and gallic acid (20, 40, 80, 100 and 200 μ g/ml) for24, 48 and 72 hours. Cells viability was assessed by MTS (Methyl-Thiazol-) assay. Cells were seeded at 5×103 cells/ml in 96 well plates and incubated for 24 hours. Thenmetabolites of bacteria were added, after indicated times MTS (20μ l) was added andthe absorbance was measured at 492 nm using ELISA plate reader. The percentage ofapoptosis induction was determined by flow cytometry analysis using Annexin-V fluoresceinisothiocyanate (FITC) kit (BioVision Products, CA, USA) in 20, 40, 80, 100and 200 μ g/ml concentration of gallic acid at 48 hours incubation. Results: Gallic acid decreases significantly the viability of SKBR3 cell line in a timeand dose dependent manner. So that the most effective concentration of this substancewas 200 μ g/ml and 72 hours after treatment (P< 0. 05). According to the data of Annexin-PI, the highest apoptosis induction rate was seen in 200 μ g/ml (P< 0. 05). While gallicacid in various concentrations had no significant effect on normal fibroblast cells. Conclusion: Objective of the present study is effect of gallic acid on proliferation and apoptosisof the human breast adenocarcinoma cell lines SKBR3 and normal fibroblasts cells.

Background: Tenderness, pain, muscle weakness, and limited range of motion (ROM)are symptoms of myofascial pain syndrome, which leads to restrictions on physical, occupational and social activities and ultimately reduction of productivity and qualityof life. Different methods of rehabilitation are used to improve the symptoms of thesepatients. One of the new methods is the use of kinesio tape. The aim of this study wasto evaluate the effect of kinesio tape on neck pain and disability and also musclestrength in myofascial pain syndrome. Methods: In this single-blind randomized clinical trial, from June to November 2017 inImam Hossein Hospital of Mashhad, Iran, thirty individuals (male and female) withMyofascial pain syndrome were divided into two groups (treatment and control), randomlyby lottery. In treatment group, the kinesio tape with appropriate tension was applieddirectly over pain place and on upper trapezius muscle; and control group receivedplacebo kinesio tape (kinesio taping without tension). In this study, before andthree days after application of kinesio taping, numerical pain rating scale (NPRS), neckdisability index (NDI) and manual muscle testing (MMT) were used to assess pain, disability and strength, respectively. Results: To compare the effect of treatment, the mean of variables were compared withindependent sample t-test before and after treatment. Pain and strength of upper trapeziuswere significantly different in both groups (P< 0. 05), but in neck disability therewas not significantly difference (P< 0. 05). Then, for a closer examination, the paired ttestwere used to compare the mean of disability before and after the treatment and resultshowed a significantly different in the treatment group and was not significantlydifferent in the control group. Conclusion: According to the results of this study, kinesio tape can reduce neck pain, increase the strength of upper trapezius, and ultimately reduce the disability of neck inmyofascial pain syndrome. Therefore, this method can be used in rehabilitation clinicsto improve the symptoms of patients with myofascial pain syndrome.

Background: Due to intrinsic heterogeneity of cellular distribution and density withindiffusion weighted images (DWI) of glioblastoma multiform (GBM) tumors, differentiationof active tumor and peri-tumoral edema regions within these tumors is challenging. The aim of this paper was to take advantage of the differences among heterogeneityof active tumor and edematous regions within the glioblastoma multiform tumors inorder to discriminate these regions from each other. Methods: The dataset of this retrospective study was selected from a database whichwas collected at the medical imaging center, Imam Khomeini Hospital, Tehran Universityof Medical Sciences, Iran. The quantification was performed as a part of a researchstudy being supported by the Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Iran, between May and September 2017. Twentypatients with histopathologically-confirmed GBM tumors who had been imaged on a3T MRI scanner prior to their surgery, were included. Conventional and diffusionweighted MR images had been carried out on the patients. The regions of interest includingthe regions of active tumor and edema were identified on MR images by anexpert and overlaid on ADC-maps of the same patients. Histogram analysis was performedon each of these regions and 14 characteristic features were calculated and thebest feature combination for discrimination of active tumor from edema was obtained. Results: It was shown that by combining 8 out of 14 histogram features, including median, normalized mean, standard deviation, skewness, energy, 25th, 75th, and 95th percentiles, differentiation with accuracy of 96. 4% and diagnostic performance of 100%can be achieved. Furthermore, by combining mean, energy, and 75th percentile featuresof histograms, the active tumor region can be discriminated from the edematous regionby 92. 7% of accuracy and 98. 9% of diagnostic performance. Conclusion: The present study confirms that the heterogeneity of cellular distributioncan be a predictive biomarker for differentiation of edematous regions from active tumorpart of GBM tumors.

Background: One of the most important causes of chronic liver disease is hepatitis Cvirus (HCV), which causes liver cirrhosis and hepatocellular carcinoma. To control theprevalence of the disease, knowledge and information in risk factor of HCV are required. The aim of this study was to compare the risk factors of infection between HCVpatients with genotypes 1a and 3a. Methods: This is an observational analytical study. HCV patients who referred to theclinic of hepatology, Rasoul-e-Akram University Hospital from July 2015 to July 2017, were assigned to the genotype 1a and 3a. Demographic (age, sex, family history), clinical(cirrhosis, hepatocellular carcinoma) and laboratory data, history of intravenousdrug and alcohol usage, and history of imprisonment were gathered and compared betweentwo groups. All the patients completed the informed consent form. Data analysiswas performed by SPSS software, version 22 (IBM SPSS, Armonk, NY, USA). P valueless than 0. 05 was considered statistically significant. Results: Overall, 97 HCV patients were included in this study. Mean age was 45± 12years and 78 (80%) of patients were male. Among them, 58 (60%) and 39 (40%) hadgenotype 1a and 3a. respectively. History of injection drug usage was recorded in 34/39(87%) of patients with genotype 3a, and significantly higher in genotype 3a as comparedto genotype 1a [OR adj: 3. 1, CI (1. 3-6. 2)]. Also, in this study, genotype 3a wassignificantly recorded in younger patients [OR adj: 1. 7, CI (1. 2-4. 1)]. However, cirrhosisand hepatocellular carcinoma was more common in patients with genotype 1a ascompared to genotype 3a [OR adj: 2. 05, CI (1. 6-5. 4) and OR adj: 2. 8, CI (1. 3-5. 7)] respectively. Conclusion: According to the results of this study, hepatitis C virus transmission riskfactors differed in genotypes 3a and 1a. Genotype 3a is found among young patientswith a history of intravenous drug usage and genotype 1a in patients with cirrhosis andhepatocellular carcinoma.

Background: Rash is a common complaint in children that has many causes and thevarious differential diagnoses. Therefore, urgent and appropriate clinical diagnosis isnecessary to provide immediate medical intervention. Therefore, the purpose of thisstudy was to investigate the causes of skin rash in children hospitalized due to rash. Methods: This descriptive-analytic study was performed on all patients admitted forskin rashes in Hazrat Masoumeh Hospital in Qom, Iran from 2010 to 2015. In thisstudy, the data of 317 patients who were admitted to the early diagnosis of rash werecollected from patients' files and recorded in the checklist. Results: According to our study, the most common causes of skin rashes in childrenwere viruses with a share of 40. 69% (129 cases), allergic causes being as prevalent as21. 77% (69 cases) and drug induced rashes that accounted for 20. 50% (65 cases). Based on the site and type of rashes, the most common type of rashes were maculopapularrashes with 42% and hives with 31. 9% prevalence, and the most common site ofinvolvement was diffuse involvement that would account for 84% of the cases. In termsof drug use history, 35. 6% had a history of antibiotic use prior to admission, and 14. 5%had an antiepileptic drug use history. There was a significant relationship between thecause of rashes and the season of presentation (P< 0. 05) as well as the age of presentation(P< 0. 05). Conclusion: This study showed that there is a significant relationship between the seasonand age of occurrence, but the use of these factors as a benchmark for the diagnosisof rash requires more studies. Paying attention to the causes of rash in children, knowingabout these factors, and continuous evaluation of these patients can help in advancinga proper management of the problem of patients. The most frequent factors wereviruses and then allergic and pharmaceutical agents, and the most common type wasmaculopapular.

Background: Despite advances in diagnosis and treatment, leishmaniasis is now considereda severe public health problem, particularly in developing countries, such asIran. Leishmaniasis is among the six most important, parasitic diseases of the worldaffecting 88 countries in almost every continent. The disease is complex with differentclinical presentations such as visceral, cutaneous and mucocutaneous forms. Cutaneousleishmaniasis (CL) is the most common form of the disease in Iran. Antimony compoundsare the first line treatment of CL. The treatment of leishmaniasis in endemicareas relies on chemotherapy, and in several parts of the world the mainstay remains thepentavalent antimony (SbV)-containing drugs Pentostam (sodium stibogluconate) andGlucantime (meglumine). There is no comprehensive study on treatment failure rate ofthis compounds. This study was designed to evaluate treatment failure rate and possibleinvolving factors of antimonial resistance in CL to facilitate and improve treatmentstrategies of this disease. Methods: All patients with CL referred to Skin Disease and Leishmaniasis Research Center(SDLRC), from October 2011 to October 2013, treated with antimony compoundswere assessed in this study. Patient characteristics (gender, age and place of residence), number, type and location of the lesions, comorbidities and type of treatment were recordedand analyzed. Results: Rate of treatment failure with Meglusan was 4. 3%. Failure rate in men and inpatients with previous history of cutaneous leishmaniasis was more than women or patientswithout CL history (P= 0. 000, 0. 024 respectively). The results of this studyshowed that treatment failure was higher in patients with systemic treatment than intralesional(IL) or combination therapy (both IL and systemic treatment) group but thisdifference was not statistically significant. Also, size and number of the lesions, woundinfection, the patient's age, location, education and occupation do not have a significantcorrelation with treatment failure. Conclusion: Greater treatment failure rate of Meglusan compared to Glucantime (4. 3%versus< 1%, respectively) is an important issue to be considered in CL therapeutic strategy.

Background: Developmental and behavioral disorders are the most prevalent problems inchildren after infection and trauma. Growth and development are influenced by genetic, social and environmental factors that incept of the early life of the fetal and neonatal periods. Due to the importance of the development in children, this study was conducted to determinethe relationship between growth indices at birth and developmental status in infancy. Methods: This case-control study investigated 6 to 18 months old infants, who referred tocomprehensive health centers affiliated to Qazvin University of Medical Sciences, Iran, from August to December 2017. The sample size in this study was 200 infants and theparticipants were evaluated in two groups of 100 subjects (developmental delay and normaldevelopment). Anthropometric indices at birth were collected from healthcare records, and developmental status was measured using the ages and stages questionnaire(ASQ). The developmental status of the children was measured in five domains, i. e., motor(gross and fine motor skills), problem-solving, personal-social skills and communication. A significance level was considered statistically <0. 05. Results: The mean age of the infants in the developmental delay group was 12. 63± 1. 72months and the mean age of the infants in control group was 12. 68± 1. 69 months and45. 6% of children in the developmental delay group were female and 54. 4% of children inthe developmental delay group were male. The most prevalence developmental delay incase group was in the area of personal-social domain (26. 9%) and the lowest prevalencedevelopmental delay in the area of the gross motor (12. 7%). No correlation was foundbetween head circumference (P= 0. 32) and height at birth (P= 0. 11) and developmentalstatus. However, there was a significant relationship between developmental delay in thearea of the communication (P= 0. 04) and gross motor (P= 0. 02) with birth weight. Pearsoncorrelation indicate a correlation between developmental delay in the area of the grossmotor and birth weight (P= 0. 01). Conclusion: It seems that birth weight was a factor that is associated with developmentaldelay. In this study low birth weight correlated with developmental delay in communicationand gross motor aspects of ASQ.

Background: Polycystic ovary syndrome (PCOS) is an endocrine disorder and one of themain reasons of infertility in women. PCOS causes many symptoms in women, one of themost important of them is ovulation failure. It affects the women at the age of fertility. Many factors are detected to exacerbate PCOS including insulin, anti-Mullerian hormone, obesity and androgen. The aim of this study was to evaluate endocrine and metabolic factorsand its relation with obesity in patients with polycystic ovary syndrome in exacerbationof disease. Methods: This cross-sectional study was carried out at the Caucasus Infertility TreatmentCenter of Ardabil from July 2015 to March 2016 and on 321 patients with polycystic ovarysyndrome. Blood samples were investigated to measure serum levels of fasting insulin, dehydroepiandrosterone sulfate (DHEAS), 17OHP, fasting blood sugar, sex hormonebinding globulin (SHBG), anti-Mullerian hormone, vitamin D, total testosterone, freetestosterone, prolactin, FSH, LH and TSH. Also, body mass index (BMI), duration ofinfertility and age were measured. BMI was evaluated to measure the obesity of patients. Results: We were able to demonstrate significantly high level of total testosterone andfasting insulin in PCOS women by having weight gain (P< 0. 05). Response to drug wassignificantly increased with reduced weight of these patients (P= 0. 02). The level offasting blood sugar (P= 0. 01) and anti-Mullerian hormone (P< 0. 05) were increasedsignificantly with access in PCOS. On the other hand, our data showed that duration ofinfertility was increased by growing the age of patients (P< 0. 05). Conclusion: Insulin resistance, obesity, hyperandrogenism and metabolic syndrome arevery important factors in pathogenesis of PCOS. These factors could affect the fertilityof women by effecting the reproductive processes. Therefore, it is better in the patientswho are older, treatment strategies further underline on reduce these factors (insulinresistance, obesity and hyperandrogenism) to prevent disease progression and increaseduration of infertility.

Background: According to the direct connection between congenital hypothyroidismand iodine deficiency in pregnant women, also relatively high incidence of congenitalhypothyroidism in some areas of Kerman province, especially Raver district located inNorth of Kerman province, this study was performed to determine and compare theurinary iodine concentration (UIC) in pregnant women referring to health centers. Methods: This cross-sectional study was done during March 2014 and May 2015. Inclusionand exclusion criteria to be considered and UIC were measured by spectrophotometryin 384 and 374 pregnant women in Ravar and Kerman cities, Iran. Samplingmethod for this study was all of pregnant women in Ravar and random stratified samplingin Kerman. data were collected using a structured questionnaire. All statisticalanalyses were performed using SPSS Software, version 20. 0 (IBM SPSS, Armonk, NY, USA). Chi-square test, Pearson's correlation coefficient and Logistic regression wereused for associations and differences. Results: The mean UIC was 200. 21 μ g/L in pregnant women of Ravar and 238. 79 μ g/Lin pregnant women of Kerman. 22. 7% of pregnant women were with low concentrationsof iodine, 57. 8% within the normal range and 19. 5 percent were with high iodineconcentrations in Ravar. While 5. 3 percent of pregnant women were with low concentrationsof iodine, 54. 5% were within the normal range and 40. 1% were with high UICin Kerman. There were no significant differences between demographic variables andUIC in the two regions (P> 0/05). Multivariate regression models showed significantconnections between the residence and UIC pregnant women (P< 0. 001). Conclusion: The results of this study showed that UIC in pregnant women of Ravarwas significantly lower than Kerman and the place of living can be considered as apredictor of UIC in pregnant women.