TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ)
Year:2017 | Volume:75 | Issue:7|Papers Count:12

Wound healing and reduction of its recovery time is one of the most important issues in medicine. Wound is defined as disruption of anatomy and function of normal skin. This injury could be the result of physical elements such as surgical incision, hit or pressure cut of the skin and gunshot wound. Chemical or caustic burn is another category of wound causes that can be induced by acid or base contact irritation. Healing is a process of cellular and extracellular matrix interactions that occur in the damaged tissue. Wound healing consists of several stages including hemostasis, inflammatory phase, proliferative phase and new tissue formation which reconstructs by new collagen formation. Wounds are divided into acute and chronic types based on their healing time. Acute wounds have sudden onset and in normal individuals usually have healing process of less than 4 weeks without any residual side effects. In contrast, chronic wounds have gradual onset. Their inflammatory phase is prolonged and the healing process is stopped due to some background factors like diabetes, ischemia or local pressure. If the healing process lasts more than 4 weeks it will be classified as chronic wound. Despite major advances in the treatment of wounds, still finding effective modalities for healing wounds in the shortest possible time with the fewest side effects is a current challenge. In this review different phases of wound healing and clinical types of wound such as venous leg ulcer, diabetic foot ulcer and pressure ulcer are discussed. Also acute wound models (i.e burn wounds or incisional wound) and chronic wound models (such as venous leg ulcers, diabetic foot ulcer, pressure ulcers or bedsore) in laboratory animals are presented. This summary can be considered as a preliminary step to facilitate designing of more targeted and applied research in this area.

Herbal essential oils are volatile, natural, complex compounds formed by medicinal plants as secondary metabolites. As reported by international organization for standardization (ISO), the term "essential oils" (EOs) is defined for a product obtained from vegetable raw materials or fruit using distillation with water or steam. The EOs are generally complex mixtures of volatile organic compounds include hydrocarbons (terpenes and sesquiterpenes) and oxygenated compounds (alcohols, esters, ethers, aldehydes, ketones, lactones, phenols, and phenol ethers) compounds. In medicinal plants, the EOs chemical profile usually very varies because of both intrinsic (sexual, seasonal, ontogenetic, and genetic variations) and extrinsic (ecological and environmental aspects) factors, also the EOs composition differs not only in the number and type of molecules but also in their stereochemical structures, and can be very different according to the extraction method. EOs represents a “green” alternative in the nutritional and pharmaceutical fields due to reported antimicrobial, antioxidant, antiinflammatory and anticancer properties thus, in recent times; EOs has gained great popularity as consumers have developed a particular ever-growing awareness toward the use of natural ingredients, especially in food and household. Therefore, the present review provides a comprehensive summary on the method of preparation of EOs from medicinal plants, chemical composition analysis, their biological and pharmacological effects and their potential benefits on health level. Present information was compiled using keywords “Essential oil, Medicinal Plants and Natural additive in scientific database as Science Direct, Elsevier, PubMed, Google scholar and SID, until 2005 to 2015. EOs have great antimicrobial activity and mostly destroy bacteria, fungi and viruses without harmful effects on consumer’s health. Finding of this study showed that the Thymol, a-Pinene, b-Pinene, Cumin Aldehyde, Carvacrol, Germacrene, Linalool were the main components. Also, EOs have antioxidant, anti-inflammatory and many other pharmacological properties which enhance their potential application. EOs have potential biological and pharmacological activities and so have many applications in pharmaceutical and food industries.

Background: Head and neck squamous cell carcinoma (HNSCC) is the malignancy of squamous cells (the epidermal layer of skin) in cavities in head and neck includes: larynx, pharynx, paranasal sinuses and oral cavity. The main goal of this research was to understand the effect of mutations in two important genes (KRAS and BRAF) in RAS/MAP kinase (EGFR) signaling pathway in tumor cells with head and neck squamous cell carcinoma in Iran.Methods: The present cross-sectional study performed from October 2015 to September 2016 on 40 patients suffering from head and neck squamous cell carcinoma, all confirmed by pathology department of Imam Khomeini hospital. Tumor samples were achieved from the surgical cancer department of Imam Khomeini hospital and stored in liquid nitrogen until starting tests. The tests done in genetic laboratory of Tehran University of Medical Sciences. Techniques we used in this research, were DNA extraction based on phenol-chloroform approach, Multiplex PCR (M-PCR) to amplify mentioned exons and KRAS/BRAF strip assays to detect mutations in mutated hotspots in exon 2 of KRAS and codon V600E in BRAF gene.Results: In this study, we observed 7 mutations in codons 12 and 13 exon 2 in KRAS gene (about 17.5%) and 4 mutations in codon V600E in BRAF gene (about 10%) of obtained tumor samples. The hotspot mutation in codon 12 were Asp (10%) and Ser (5%) respectively. In BRAF, the most common mutation, as we expected according to other researches, was observed in codon V600E. We also observed that 29 people of these patients were male (about 72.5%) and 11 patients were female (about 27.5%). Moreover, 28 patients were over 50 years, while 7 patients were below the age of 50.Conclusion: The results of this study showed that mutations in genes KRAS and BRAF especially in studied hotspots, and the effects on their molecules in EGFR signaling pathway are important in involving head and neck squamous cell carcinoma, as other cancers. These findings may be considered in choosing drugs for targeted chemotherapy.

Background: There are several techniques for reducing the delivered dose from CT (Computed tomography) scanning such as the automatic exposure control (AEC). This technique modulates the tube current regarding the patient size and weight. The aim of this study was to estimate the effect of the AEC on the radiosensitive organs effective doses in women undergoing chest CT scanning.Methods: This study was a cross-sectional, analytical and quantitative study that was performed during 3 months in the imaging section of the Firoozgar educational and therapeutic hospital (belonging to Shahid Beheshti University of Medical Sciences) in the spring of 2017. CT scan exposure parameters were gathered and registered for 54 women undergoing chest CT scan. Twenty-five of these scans were performed using AEC system and 29 of them were performed without using AEC. CT dose indexes in the center and peripheral regions of the standard phantom were calculated using the exposure parameters. Weighted CT dose index was also calculated and effective organ doses were obtained using CT-Expo software, version 2 (Medizinische Hochschule, Hannover, Germany) for two mentioned groups. In addition, noise was measured for these two groups as an image quality parameter.Results: Calculated weighted CT dose indexes were 9.94 mGy and 12.46 mGy using AEC system and without using AEC, respectively. The calculated effective doses were equal to 5.4 mSv and 6.3 mSv using AEC and without using AEC, respectively. Maximum organ effective doses were 15, 14, 14 and 14 mSv for breast, esophagus, lung and thymus respectively in the non-using AEC system imaging technique.Conclusion: Our measurements indicated a decrease about 15% in weighted CT dose index (from 12.46 to 9.94 mGy) using AEC system. Beside of this fact, the noise increased about 11.3% (from 4.2 to 4.74) using AEC system. So, it can be said that using of AEC was an effective way for dose reduction in women undergoing chest CT scanning, and the additional noise was in the acceptable range.

Background: Patellofemoral pain syndrome (PFPS) is known as one of the most frequent knee diseases and is the most frequent cause of anterior knee pain. Despite the high prevalence of the disease, its predisposing factors are not clearly known. Neuromuscular control disorders of hip and lumbopelvic complex and instability of core redounds to instability of whole movement pack chain. The aim of the present was to comparing the electromyography activities of core muscles and muscles around the knee joint during gait in patients with PFPS with healthy subjects.Methods: This descriptive-analytic case-control study was carried out in School of Rehabilitation in Shahid Beheshti University of Medical Sciences, Tehran, Iran. The present study was carried out during 10 months (April to February in 2016). Thirty-two subjects containing 17 patients with patellofemoral pain syndrome (10 females and 7 males) and 18 healthy subjects (10 females and 8 males) participated in this study. In both groups the electrical activities of some of the muscles around the knee joint and the core muscles containing vastus medialis (VM), adductor longus (AL), gluteus maximus (G Max), external oblique abdominis (EOA), internal oblique abdominis (IOA), transverse abdominis (TA) and multifidus (M) were recorded during gait. Onset and offset time, duration and intensity of muscles activities were compared between two groups.Results: The results of the study showed that duration and intensity of the electrical activity of the gluteus maximus (respectively P=0.03, P=0.035) and offset time of electrical activity of the internal oblique abdominis (P=0.04) and the transverse abdominis (P=0.03) during gait, were significantly different between two groups. The external oblique abdominis and the multifidus electrical activities had not any significant differences between two groups (P>0.05).Conclusion: It seems that electromyographic activities of some of core muscles in patients with patellofemoral pain syndrome in comparison with healthy subjects are different. However, there was no differences in electromyographic activities in some of the muscles around the knee between patients and healthy subjects.

Background: It is known that irisin plays a role in regulating energy balance and body weight. Hence, the aim of this study was to evaluate the effects two models of high intensity interval training and moderate intensity continuous training on the irisin serum and peroxisome-proliferator-activated receptor co-activator-1a (PGC-1a) gene expression in skeletal muscle tissue of male rats.Methods: This experimental study was conducted in Baqiyatallah University of Medical Sciences during the summer months of 2016. In this study, 32 male Wistar rats (mean weight=250±55 g, age: 8 weeks) were randomly and equally were divided in to 4 groups: basic control (CO), control of eight weeks (CO8w), moderate intensity continuous training (MICT) and high intensity interval training (HIIT). CO group rats at baseline were killed and CO8w group was held concurrently with the experimental group but did not participate in any exercise training. HIIT and MIET groups for 8 weeks also did moderate continuous training (15-60 minute at 15-30 m/min) and sever intensity continuous training (4-8 one-minute intense interval of 28-58 m/min, with a 3- 7 one-minute slow interval of 28-58 m/min). The enzyme-linked immunosorbent assay (ELISA) method for measuring serum irisin levels and real-time PCR method for the relative expression of mRNA of PGC-1α gene were used. The data were analyzed by one-way analysis of variance (ANOVA) and Tukey's post-hoc test at P<0.05 level. All analyzes were performed using SPSS software, version 21 (SPSS Inc., Chicago, IL, USA).Results: The results showed that the relative expression of mRNA of PGC-1a gene significantly increased in both exercise groups compared to the control groups (P=0.001). In contrast, in comparison of control groups, neither HIIT nor MICT had no significant effects on serum irisin levels (P=0.20).Conclusion: The results show that the two methods of exercise training may be the upstream pathway's activation can increase transcription of the PGC-1a gene (a key regulator of energy metabolism and mitochondrial biogenesis) in skeletal muscle, but doesn' t make a significant change in the levels of serum irisin.

Background: One the ways to deal with the adverse effects of oxidative stress caused by exercise activities is to use oral antioxidant supplements or to apply natural remedies. Sesamin is the most prominent lignan compound found in sesame seeds, one of the two highest sources of lignans in the human diet (the other being flax). Sesamin is catered to be a nutritional supplement that confers antioxidant and anti-inflammatory effects or possibly being an estrogen receptor modulator and fat burner. For this purpose, the present study was conducted to evaluate the effect of 10 weeks supplementation of sesamin and aerobic exercise on plasma levels of total antioxidant capacity and glutathione peroxidase in athletic men.Methods: In this quasi-experimental study, in Azarbaijan Shahid Madani University of Tabriz City from January to March of 2016, 40 male subjects aged between 25 and 20 were randomly selected from placebo (10 subjects) and aerobic exercise (10 students), aerobic training+sesamin (10 people) and sesamin (10 people). The aerobic exercise protocol is (ten weeks / three days / 30-35 minutes). Blood samples were collected from subjects in six stages to evaluate the considered variables. Measurement of levels of antioxidant capacity and glutathione peroxidase measurements were conducted by the Antioxidant capacity and GPX assay kit (ZellBio, German). For data analysis, repeated measures of variance analysis at a significant level of 5 hundredths were used by employing SPSS software, version 20 (SPSS Inc., Chicago, IL, USA).Results: Subjects who took sesamin supplementation and performed aerobic exercise showed a significant difference in the levels of total antioxidant and glutathione peroxidase capacity in the groups (P<0.05). Also, the changes in total antioxidant and peroxide levels after interference (steps 4, 5, 6) and before interference (steps 1, 2, 3) had meaningful differences in obtained results (P=0.001). Also, the interactive effects of group and time on total antioxidant capacity and glutathione peroxidase were also significant (P=0.001).Conclusion: Aerobic exercise and supplementation of sesamin is an effective method to improve the health of mens athlete's immune system. In addition, combining supplementation with aerobic exercise can increase some of the beneficial effects of exercise during a 10-week period.

Background: Suicide is one of the main health problems in different societies and is associated with different risk factors. The result of a suicide attempt is directly related to the selected method. Invasive suicides are known as violent methods of self-harm and are usually happened in different patterns of age and gender. The aim of this study was to investigate the outcome and varieties of suicide via invasive methods in a long term period in Ilam province, Iran.Methods: In this retrospective study, the required data, including demographic variables, outcomes and the kind of invasive method was extracted from a comprehensive registration system of suicide cases, recorded by Ilam University of Medical Sciences (IUMS), to investigate the invasive suicides during the 1993-2013 years. The study was approved by the Ethics Committee of Ilam University of Medical Sciences and based on this approval the permission to access the suicide data was issued. Data were entered into the SPSS 20 software (SPSS Inc., Chicago, IL, USA) and using descriptive statistical methods and chi-square were analyzed based on completed or attempted outcome of suicide.Results: Among a total of 1516 cases of invasive suicide, 643 (42.6%) were attempted and 867 (57.4%) were completed suicides. Self-immolation method showed the highest frequency of suicide (both completed and attempted). The highest frequency of completed suicide was occurred in females (52.8%) but the attempted suicide was higher in males (63.6%). The age groups of 25-34 years and above 65 years indicated the highest frequencies of attempted and completed suicides respectively.Conclusion: One of the main objectives of this study was identification of high risk groups who used the invasive methods for suicide commitments, based on their epidemiological characteristics such as gender and age. The results showed that women and elderly individuals were among the high-risk groups who committed completed suicide using the invasive methods and self-immolation attributed the most frequent method among invasive methods for suicide in Ilam province which resulted in death.

Background: Vulvovaginal candidiasis (VVC) is a common infection, affecting up to 75% of women during their lifetimes. Approximately 5% of patients may experience recurrent VVC.Candida albicans is the most common causative agent of VVC. The objectives of this study were identification of candida species isolated of women with vulvovaginal candidiasis by molecular method in Arak city.Methods: In this descriptive cross-sectional study, between Jun 2015 to March 2016 from 210 patients with vulvovaginal candidiasis referred to gynecology and obstetrics clinics in Arak city, Iran. Vaginal sampling was performed by wet sterile swabs. Samples were collected from vaginal discharge, vaginal posterior fornix, and sides of the vaginal wall. The swabs were investigated for direct exam and cultured on Sabouraud’s dextrose agar medium contain chloramphenicol. Yeast isolates DNA were identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Fungal genomic DNA was extracted from each isolate colony, glass bead method and after amplification of ITS1-ITS4 region with PCR assay, digested by MSP I restriction enzyme.Results: From 210 patients with vulvovaginitis, 95 (45.2%) patients showed VVC. These patients were positive for Candida growth in culture and were infected with one Candida species. The age range of women with vulvovaginitis was between 14-60 years and the most VVC cases were in age group of 21-30 years. The most common Candida species isolated wereCandida. albicans (70.5%), C. glabrata (20%), C. tropicalis (7.4%) andC. parapsilosis (2.1%).Conclusion: Regarding to the results of this study, C. albicans was the most common Candida species, isolated from patients with vulvovaginal candidiasis and approximately 30% of this infection causing by non-albicans species of Candida.

Background: Abnormal placental adhesion refers to abnormal placental implantation in which the anchoring placental villi attach to myometrium and even uterine serosa which may invade the bladder and bowels. One of the most important complications of these abnormalities is severe hemorrhage during placental removing which may even necessitate cesarean hysterectomy. Since uterine conservation is an important issue especially in young women at reproductive age, conservative management has a cardinal role to reduce bleeding during surgery. Uterine artery embolization as the first line conservative approach is reserved for women that fertility preservation is very important or whom the risk of severe bleeding during cesarean section is very high due to abnormal placental adhesion. Use of embolization in unstable patients is limited because it usually cannot be performed as rapidly as other measures. The aim of this study was to report two cases of uterine artery embolization before cesarean section in pregnant women with abnormal placental adhesions.Case presentation: Two 35 and 37-year-old pregnant women at gestational age of 34 weeks diagnosed as placenta previa and abnormal placental adhesion (placenta percreta) who intended to preserve their fertility underwent bilateral uterine artery embolization before cesarean section in Ghaem hospital, Mashhad University of Medical Sciences, Iran at September 2016. Bleeding during surgery was significantly decreased and uterine preservation was successfully preformed without any serious complications during and after the surgery. In the next follow-ups, they had normal menstruation about two months after the cesarean section.Conclusion: In placental adhesive disorders, uterine artery embolization at the time of cesarean section could significantly decrease bleeding during surgery, so uterine and fertility preservation could be performed in this situation.