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Serum inhibin levels in polycystic ovary syndrome: a case control study
M. Lankarani, N. Valizadeh, R. Heshmat,
Volume 64, Issue 5 (1 2006)
Abstract

Background: Polycystic ovary syndrome(PCOS) is the most common endocrinopathy in women and the most common causes of anovulatory infertility.Inadequate follicule stimulating hormone is hypothesized to be a proximate cause of anovulation.Inhibins are glycoprotein hormone produced by the granulosa and theca cells of the ovary that selectivly inhibits FSH production and or release from the pituitary. The possible role of inhibin in the etiology of polycystic ovary syndrome (PCOS) is controversial. This study was designed to investigate levels of serum inhibin in women with PCOS.       

Methods: In a case-control setting 41 women with PCOS from the endocrine and gynecology and obstetrics clinic of Shariati Hospital and 44 women with normal cycles (control group) aged 15-40 year-old were evaluated. In all patients with PCOS and control women appropriate medical history was taken and physical examination was done.Serum inhibin levels were compared in two groups. Statistical analysis was performed using the Mann -Whitney U test

Results: Mean age of cases and controls was 23.6±5.3 and 23.1 ±3.9 years, respectively. Mean body mass index (BMI) in cases and controls were 25.07±5.45 and 21.33± 2.46 Kg/m2, respectively. There was no statistically significant difference in mean age between the two groups (p > 0.05) but mean BMI was significantly different between the two groups (p < 0.001). Mean serum levels of inhibin in cases and controls were 1.62±1.23 and 2.26±2.26 U/ml, respectively which was not significantly different between the two groups (p: 0.168).

Conclusion: There was no significant difference in serum inhibin levels between patients with PCOS and healthy women. We concluded that basal inhibin levels cannot be used for routine screening in women with PCOS. Further study is needed to determine the role of inhibin in these patients with assay of its two subunits (Inhibin A and B).


Histopathological and histomorphometrical effects of atorvastatin on experimental femoral cortical bone defect healing in rats 
Mousavi Gh, Mohajeri D, Rezaie A, Valilu M, Alimohamadi A,
Volume 70, Issue 2 (4 2012)
Abstract

Background: Bone remodeling has always been the goal of surgeons for a long time. Recently, it was shown that statins that are commonly prescribed for lowering cholesterol also have beneficial effects on bone healing. Therefore, the present study was undertaken to evaluate the probable effects of atorvastatin on osteogenesis in the rat femur.

Methods: This experimental study was conducted on 30 male Sprague-Dawley (SD) rats. The animals were divided randomly into one control and two experiment groups. After induction of anesthesia, a hole of 2 mm in diameter was made in femur width. The control group received physiological serum but the experiment groups one and two, respectively, received 10 and 20 mg/kg/PO of atorvastatin on daily basis. After euthanizing the rats, histopathological and histomorphometrical evaluations of the bones were performed 45 days after the intervention.

Results: In the control group, the defects seemed to be filled with woven bone and bone marrow, depictive of a poor osteogenic activity. In the experiment groups, many osteoblast groupings and young bone trabeculae had been formed and bone trabeculae were more organized. Histomorphometric results, showed that atorvastatin had significantly promoted bone healing in the experiment groups compared with the controls (P<0.001). Moreover, the analysis showed that atorvastatin had more significant effects in group three receiving high doses of the medication in comparison with group two (P<0.001).

Conclusion: The findings of this study showed that atorvastatin is capable of stimulating osteogenesis in rats.


Efficacy of education with American Society of Health system Pharmacists guidelines on the prevention of stress ulcer
Naser Gharebaghi , Mohammadamin Valizade Hasanloei, Seied Hasan Adeli , Seied Arash Mansuri Zangir , Javad Rasuli ,
Volume 71, Issue 10 (January 2014)
Abstract
Background: Stress Ulcer Prophylaxis (SUP) is important in patients in Intensive Care Units (ICU). In this study, we evaluated the efficacy of the American Society of Health System Pharmacists (ASHP) guidelines, for stress ulcer prophylaxis. Methods: In this Quasi experimental study, data of patients that admitted to the ICU of Imam Khomeini Hospital of Urmia was recorded for three months. Then our guideline that was selected on the basis of ASHP guidelines were presented to physicians for one month and then patients’ data were collected again. The patients that hospitalized due to acute gastrointestinal bleeding and died in the early hours of admission were excluded. The data were analyzed. Results: This study involved 234 patients, of them 112 patients (91.1%) in the pre- intervention period and 99 patients (89.2%) in the post-intervention period had received acid-suppressive therapy (AST) (P=0.632). Of 77 patients (62.8%) in the pre- intervention period and 88 (79.3%) in the post-intervention period had an indication for SUP according to our ASHP-based guideline (P=0.005). Of the patients without an indication for SUP, 39 of 123 (31.7%) received AST in the pre-intervention period versus 18 of 111 (16.2%) in the post-intervention period (P=0.006). of 112 (91.1%) cases in the pre-intervention period compared with 93 (83.8%) cases of the prescription drug order was incorrect (P=0.092). Gastrointestinal bleeding were in five patients (4.1%) found during the pre-intervention period and 8 (7.2%) cases in the post-intervention period (P=0.295). Conclusion: In this study the majority of cases not been in accordance with the ASHP-based guideline and our education did not affect the quality of stress ulcer prophylaxis. It seems that more attention to the training of physician in the prophylaxis of stress ulcer can be effective in improving the health status of patients and additional costs may be reduced.
Preventive effects of tomato pulp on oral pre-neoplastic changes in-duced by 4-Nitroquinoline-1-oxid in the rat
Mohammad Mashayekhi , Daryoush Mohajeri , Mohammad Reza Valilu,
Volume 72, Issue 5 (August 2014)
Abstract
Background: Squamous cell carcinoma (SCC) is the most frequent oral cancer. Protec-tive effects of the consumption of vegetables and fruits on various forms of cancer in-cluding oral cancer have been determined. Tomato (Solanum lycopersicum L.) because of its lycopene and bioflavonoids contents possesses anti-carcinogenic properties. The aim of this study was to evaluate the preventive effects of tomato pulp on pre-neoplastic changes induced by 4-Nitroquinoline-1-oxid (4-NQO) in epithelial cells of lingual mucosa in the rats. Methods: Forty-eight male Wistar rats were randomly allocated into four equal groups. Group 1 served as control. Groups 2 to 4 assigned to receive 30 ppm 4-NQO in drinking water for 12 consecutive weeks. When the feeding of 4-NQO was started to the rats of groups 3 and 4, they received tomato pulp (20 and 40 ml/kg bw) daily through the oral gavage. Finally, histological evaluations for carcinogenesis were performed for tongues epithelial tissue. Results: There were no pathological alterations in epithelial tissue of lingual mucosa in control rats. In the epithelial cells of lingual mucosa of 4-NQO treated rats, premalig-nant alterations appeared after 12 weeks of the last application of the drug. Administration of tomato pulp at both doses (20 and 40 ml/kg bw) during the experiment reduced the severity of the lesions, as well as caused a significant reduction in the frequency of pre-neoplastic lesions of tongue epithelial cells (P= 0.024 and P= 0.008). The incidence of severe epithelial cells dysplasia of lingual mucosa in the high dose treatment group was significantly smaller than of low dose treatment group (P= 0.037). Conclusion: The results obtained showed that tomato pulp is effective in inhibiting the development of neoplasms in epithelial cells of lingual mucosa induced by 4-NQO in the rat.
Relationship between type of brain injury with Bispectral Index monitoring in intubated ICU trauma patients
Omid Moradi Moghaddam, Mohammad Niyakan Lahiji , Valiollah Hassani , Farid Kazemi Gezik, Ehsan Farazi ,
Volume 73, Issue 2 (May 2015)
Abstract
Background: Bispectral Index (BIS) may be used in traumatic brain injured patients with different anatomical sites of injury to evaluate the level of consciousness. The objective of this study is to evaluate the relation between type of brain injury and the presence or absence of frontal lobe damage based on brain CT-scan with BIS monitoring in intubated acute head trauma patients admitted to the intensive care unit (ICU). Methods: Participants of this cross-sectional study consisted of 30 intubated head trauma patients over the age of 15 years old, without any known history of visual or hearing impairments, neurologic disorders, mental retardation, or frontal skin laceration, who were admitted to the ICU in Rasool Akram University Hospital, Tehran. Patients who needed muscle relaxant administration, or those who showed instability of vital signs, hypoxemia, disorders of the blood biochemistry, or blood gases, liver or kidney failure, convulsion or hypoxic encephalopathy during the study were excluded. In the first three days of admission, each patient underwent monitoring of BIS every sixty minutes for just six hours a day. All the hypnotic drugs were discontinued six hours prior to the start of monitoring and fentanyl was the only opioid, which was administered if an analgesic was required. Statistical analysis were used to evaluate the data and p-value less than 0.05 was considered statistically significant. Results: Mean age of all patients was 43.6 years with a Standard Deviation (SD) of 18.96. Presence or absence of frontal lobe injury, had no statistically significant correlations with mean BIS in each three days of study and the mean BIS total. However, mean BIS in the second and third days had statistically significant differences in different types of cranial lesions (contusion, subdural hemorrhage, subarachnoid hemorrhage, etc) which usually have different prognoses. Conclusion: Different kinds of acute traumatic cranial lesions with different prognosis may have different values in BIS monitoring. Presence or absence of frontal lobe injury, had no statistically significant correlations with BIS values.
Measurement of subcutaneous adipose tissue thickness by infrared images during liposuction surgery: brief report
Fatemeh Valipoori Goodarzi , Javad Haddadnia , Tahereh Habashi Zadeh, Maryam Hashemiyan ,
Volume 73, Issue 6 (September 2015)
Abstract
Background: Currently, there are many techniques to measure subcutaneous body fat but these methods have many limitations. In this study, we tried to provide a clustering algorithm to measure the thickness of subcutaneous fat in thermography images. Methods: For the detection of subcutaneous adipose tissue in the midline area (from pubis to the xiphoid process), imaging takes place in the right or left lateral sides of the concerned person and to detect this tissue at the left and right flank (from ribs to the iliac crest), imaging takes place from the front. This study was done on 100 subjects (50 female, 50 male) of patients referred to the Shahid Mobini Hospital of Sabzevar since April 2013/4 to December, 2013 and the thickness of their subcutaneous fat in midline abdomen from pubis to the xiphoid process and flank from ribs to the iliac crest were measured based on thermal model and using K-Means and Fuzzy c-means (FCM) clustering methods and also recursive connected components algorithm. Results: Subcutaneous fat tissue can quickly appear in the thermogram as an area of low temperature and since in the thermal images, temperature is characterized by the color, as a result, subcutaneous fat tissue must have lower levels of color (temperature) relative to internal body tissues. All the measurements based-on thermal images to determine the maximum thickness of subcutaneous fat were compared with ultrasound. The results of our method were similar to the results of ultrasound method done by a radiologist, with the acceptable approximation. Conclusion: The method presented in this paper is considered as a noninvasive and cost-effective method to measure the thickness of subcutaneous body fat.
The interactive effects of two forced and voluntary exercise training method and Nanocurcumin supplement on doxorubicin-induced hepatotoxicity in aging induced by D-galactose
Saied Kamal Sadat-Hoseini , Valiollah Dabidi Roshan ,
Volume 74, Issue 11 (February 2017)
Abstract

Background: Doxorubicin (DOX) is a commonly used chemotherapeutic agent that causes hepatotoxicity via depletion of anti-oxidants and activation of apoptosis. Present study was aimed to investigate the interactive effects of two forced treadmill running and voluntary wheel running exercise training method and Nanocurcumin supplement on hepatic damage, in aging model subjects.

Methods: This experimental research was performed in animals and exercise physiology laboratory of Faculty of Physical Education and Sport Sciences, University of Mazandaran, Iran, in April, 2014. The statistical population was eighty Wistar male rats that, received a daily injection of D-galactose solution for nine weeks (100 mg/kg body weight per day, i.p.) and then, they randomly assigned to 10 groups. The forced treadmill running protocol was progressively between 25 to 54 min/day at the intensity of 15 to 20 m/min for 5 days per week for six weeks and voluntary wheel running exercise was six weeks. DOX was administrated for 15 days (1 mg/mL/kg body weight per day, i.p.). Nanocurcumin supplement was administrated for 14 days (100 mg/kg body weight per day. orally). Superoxide dismutase and apoptosis inducing factor levels were measured by enzyme-linked immunosorbent assay (ELISA) method.

Results: Implementation of two forced treadmill running and voluntary wheel running exercise with Nanocurcumin supplement, respectively led to insignificant decrease and increase in superoxide dismutase levels in comparison with the implementation of this exercise methods alone (P= 0.955 and P= 1.000, respectively). Apoptosis Inducing Factor levels following these two training method with Nanocurcumin supplement, has insignificant decrease in comparison with the implementation of this exercise methods alone (P= 1.000 and P= 1.000, respectively).

Conclusion: Our findings suggest that, however implementation of these training methods with Nanocurcumin supplement, partly mitigates the side effects of doxorubicin, but this level of intervention is not sufficient to protect against doxorubicin-induced hepatotoxicity in aging model rats.

The effect of body status on gastroesophageal reflux after feeding among hospitalized premature infants: a randomized crossover clinical trial
Leila Valizadeh , Golnar Ghahremani , Manizheh Mostafa Gharehbaghi , Mohammad Asghari Jafarabadi Asghari Jafarabadi ,
Volume 75, Issue 8 (November 2017)
Abstract
Background: Gastroesophageal reflux is a common condition among premature infants, which causes problems such as reduced weight gain and prolonged length of hospital stay. Body status is an appropriate way to reduce this condition. However, there have been few studies conducted in this regard. The objective of this study was therefore to investigate the effect of body status on gastroesophageal reflux in premature infants.
Methods: The present research was a crossover study conducted on premature infants with a gestational age of 33-36 weeks in Al-Zahra Hospital in Tabriz, Iran, from January to March 2015. In this clinical trial, thirty-two premature infants hospitalized in this center were selected as the sample. The initial selection of the participants was based on the simple random sampling. Then the participants were allocated to groups using randomized block procedure. Each infant was under study for 4 days. After each feeding and about two hours before the beginning of next feeding, the infants were randomly and not repeatedly put in one of the following four status for 12 hours (8 am -8 pm) every day: facilitated fetal tucking posture in lateral position, free body posture in lateral position, facilitated fetal tucking posture in supine position, and free body posture in supine position. Then, the incidence of gastroesophageal reflux was measured in each of these statuses. SPSS software, version 21 (SPSS Inc., Chicago, IL, USA) was used to analyze the data at significant level of P<0.05.
Results: The results showed that there was a significant difference between facilitated fetal tucking posture in lateral position and other status (P<0.001). The incidence of gastroesophageal reflux in facilitated fetal tucking posture was lower than free body posture, but there was no statistically significant difference in this regard. Moreover, the incidence of reflux in lateral position was significantly less than those in supine position (P=0.04).
Conclusion: The findings of this study revealed that facilitated fetal tucking posture and lateral positioning reduced the incidence of gastroesophageal reflux in hospitalized premature infants.
 

Duration of kangaroo mother care and weight gain in very low birth weight preterm infant
Mohsen Haghshenas Mojaveri , Zahra Akbarian Rad , Zeynab Shafipour , Somayeh Alizadeh Rokni , Fatemeh Valizadeh ,
Volume 75, Issue 11 (February 2018)
Abstract
Background: One of the important effects of kangaroo mother care (KMC) in preterm baby is improvement in weight gain and so shortening in hospitalization, but it is not clear that how long of kangaroo mother care is effective in weight gain. The aim of this study was to determine the least effective duration of kangaroo mother care in weight gain in very low birth weights.
Methods: Preterm babies with birth weight less than 1500 gr, without chronic cardiopulmonary disease, congenital anomaly and other medical problem when receiving to 140 ml/kg/d enteral feeding enrolled the study. KMC was started when the baby has been stabled, on the mother’s appetency and ability at bedside. The mean daily weight gain in KMC period was compared with expected that (15 mg/kg/d) for the same baby. The babies with KMC≥ 7 days were divided in three groups on the basis of mean daily KMC duration (< 30 min, 30-60 min and> 60). Statistical study performed by using SPSS software, version 22 (IBM SPSS, Armonk, NY, USA) and P values of less than 0.05 were considered to be significant.
Results: In this study, 103 preterm baby (47 boys, 56 girls) less than 1500 gr were enrolled, with mean birth weight 1107.85±190.87 gr. Mean weight gain of boys in KMC period and expected that were 324.78±162.66 gr Vs. 127.46±54.66 gr (P< 0.001). In eighty-seven babies who received KMC (7-40 days) mean daily weight gain was 26.69±15.55 gr (P< 0.001). Mean weight gain in KMC period for group with< 30 min (n=19), 402.63±126.29 gr Vs. 167.21±74.20 (P< 0.001), group with 30-60 min (n=54) were 338.79±182.60 gr Vs. 220.36±66.98 (P< 0.001) and group with 60< (n=14) 352.14±236.02 gr Vs. 259.96±112.23 (P= 0.09).
Conclusion: On the basis of this study KMC less than 1 hour per day is effective in weight gain of very low birth weight preterm babies.

Noninvasive evaluation of myocardial ischemia in patients with heart problems
Mehdi Nikseresht , Mahmoud Nikseresht , Valiolla Dabidy-Roshan ,
Volume 75, Issue 12 (March 2018)
Abstract
Background: Cardiovascular diseases are the leading cause of human mortality worldwide. Myocardial ischemia is a type of cardiovascular disease that increases with age spread. Therefore, the purpose of this study was to compare non-invasive myocardial ischemia in patients with heart problems in different age groups.
Methods: This study is a causal-comparative study was conducted from July to October 2016 in the University of Mazandaran. One hundred and seventy-five (age=45-59 years) and 124 (age=60-77 years) men with heart problem participated in this study. The questionnaires of Rose angina pectoris (for assessing the risk of ischemic myocardium), lifestyle and physical activity level were completed by the participants. In addition, the anthropometric characteristics, blood pressure and peak oxygen uptake (VO2peak) of the participants were measured.
Results: The risk of myocardial ischemia in men aged 60-77 years was significantly higher than men aged 45-59 years (P=0.049). Men aged 60-77 years were significantly lower in good indices (physical activity level, VO2peak and more lifestyle indices) and higher in bad indicators (waist/hip ratio, body shape index, ankle systolic blood pressure, brachial systolic and diastolic blood pressure) than men aged 45-59 years (P<0.031, for all variables). Also, there was no significant difference in the risk of ischemia between groups, when they were similar in physical activity level.
Conclusion: It seems that the higher risk of myocardial ischemia in men aged 60-77 years, as compared to men aged 45-59 years, might be related to aging process and imbalance in the risk factors. Promoting physical activity can favorably affect the risk of myocardial ischemia in the middle-aged or elderly men. It is concluded that physical activity effectively decreased the risk of myocardial ischemia.

The relationship between vitamin D and gestational diabetes
Fatemeh Bahadori , Zahra Sahebazzamani , Leila Zarei, Neda Valizadeh,
Volume 76, Issue 9 (December 2018)
Abstract
Background: Gestational diabetes is one of the common causes of maternal and fetal complications. Due to fetal and maternal complications of diabetes, it is very important to reduce the prevalence of diabetes and its consequences. The relationship between vitamin D deficiency and type 2 diabetes has been reported. There is little information about the relationship between serum vitamin D levels and the risk of gestational diabetes mellitus (GDM). The aim of this study was to determine the relationship between the levels of vitamin D and gestational diabetes.
Methods: This case-control study was conducted in health centers of Urmia University of Medical Sciences in May 2015 until March 2016. A total of 100 pregnant women with gestational diabetes and 100 healthy pregnant women were entered into the study by nonrandom and available sampling. The level of vitamin D was measured and levels were divided into three levels. Vitamin D levels were considered less than 20 ng/ml, 20-30 ng/ml and more than 30 ng/ml as deficiency, insufficiency and sufficient, respectively. Exclusion criteria include pre-pregnancy glucose tolerance, history of medical disease, and supplementation with vitamin D.
Results: The mean age of women in the study group was 30.31±5 years and in the control group was 28.83±4.95 years (P=0.06). The vitamin D levels in GDM and control groups were 7.25±4.76 ng/ml and 11.93±16.12 ng/ml, which is lower in the gestational diabetes than the control group (P=0.01). The severe deficiency of vitamin D in the gestational diabetes group and in control group were 34% and 27% respectively (P<0.0001). There was a significant difference in mean fasting plasma glucose level between gestational diabetes group and healthy pregnant group (P<0.001). There was no relationship between vitamin D levels and body mass index of pregnant women (P=0.1).
Conclusion: In this study, the majority of patients had vitamin D deficiency and in the gestational diabetes group, vitamin D deficiency was significantly higher than the control group. The severe deficiency of vitamin D in the gestational diabetes group was higher than patients without gestational diabetes.

Translation, cultural adaptation, and reliability of Persian "Copenhagen hip and groin outcome score" in athletes with hip pain: brief report
Saeed Valian, Soofia Naghdi , Noureddin Nakhostin Ansari , Shohreh Jalaie , Nasser Salsabili,
Volume 76, Issue 11 (February 2019)
Abstract
Background: Copenhagen hip and groin outcome score (HAGOS) is the only valid and reliable self-reported questionnaire for assessing symptoms and activity limitations of subjects with hip and groin problems. The aim of this study was to translate and culturally adapt the English version of the HAGOS to Persian and to evaluate its reliability in young athletes with hip and groin pain.
Methods: This cross-sectional study was performed in Tehran University of Medical Sciences, School of Rehabilitation, Iran, from June 2014 to May 2015. In order to develop the Persian HAGOS, the English HAGOS was translated and culturally adapted into Persian language based on the standard forward-backward translation and expert committee review. Then, for the test-retest reliability investigation, young male athletes suffering from hip and groin pain, recruited from sport physical therapy clinics, completed the Persian HAGOS two times with 1-2 weeks interval. Independent samples t‐test and Intraclass correlation coefficient (ICC) was used to determine the test-retest reliability of the six subscales and the total score of Persian HAGOS. The SPSS statistical software (IBM SPSS, Armonk, NY, USA) was used for all analyses.
Results: Fifty young male athletes, mean age 26.12±3.37 years (range: 18-33), participated in this study. ICC value for test retest reliability of total score was 0.74 (95% CI: 0.59-0.84). ICC values for subscales scores ranged from 0.6 for participation in physical activities subscale to 0.79 (P<0.0001) for pain subscale (P<0.0001). There were no significant differences between the test and retest scores obtained for subscales and total scores (t-test, P>0.05).
Conclusion: The HAGOS was successfully translated and cross-culturally adapted from English into Persian language. The Persian version of HAGOS is a reliable questionnaire for the evaluation of young athletes with hip and groin pain in clinics and research.

Practice of oral and maxillofacial surgeons in bisphosphonates users in Tehran: brief report
Mohadeseh Heidari, Avideh Maboudi, Sepideh Motevali , Farhad Sobouti, Mahmood Moosazadeh,
Volume 76, Issue 11 (February 2019)
Abstract
Background: Although the treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ) is very difficult, it can be prevented. The aim of this study was to investigate the knowledge and practice of oral and maxillofacial surgeons in the treatment of bisphosphonates user patients.
Methods: This was a cross-sectional study carried out by census sampling of oral and maxillofacial surgeons in Tehran, Iran from March to June 2016. The employed instrument was a questionnaire including 4 sections. The first section was to collect the demographic information of the participants. In the second part including 7 questions, the knowledge of the participants was measured. The third section with 6 questions was to assess the participants’ practice in the treatment of patients using bisphosphates. Finally, the last sections contained 4 questions. The content validity of the questionnaire was evaluated by 5 specialists in the field (two oral and maxillofacial surgeons, two periodontists, and one endodontist). To assess the reliability of the questionnaire, it was given twice with a 10-day interval to 10 of target group members. The calculation of Spearman-Brown formula revealed a correlation coefficient of 0.79.
Results: In the treatment of BRONJ, most subjects responded to risk, 1 and 2 stages patient education and symptom relief. Treatment with antibiotics and debridement surgery was chosen for patients with higher stages. From 123 oral and maxillofacial surgeons, 102 answered the questionnaires. 77.2% of the surgeons answered correctly to questions about implant insertion. This percentage was higher than other therapeutic procedures.
Conclusion: The knowledge of oral and maxillofacial surgeons as final line of referral and treatment of patients using bisphosphonates should be increased.

Measurement of pyruvate dehydrogenase enzyme in patients with diffuse large B-cell lymphoma relapse
Ali Hadi , Valiollah Mehrzad , Nazanin Vaziri , Lalaeh Shariati , Golnaz Vaseghi ,
Volume 78, Issue 2 (May 2020)
Abstract
Background: Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin's lymphoma (NHL), which is the most common type of lymphoma. NHL comprises a group of clinically and biologically diverse diseases, which range from indolent to aggressive clinical courses. Despite treatment advances in the last three decades with the use of combination immunotherapy, a significant fraction of patients relapses or are refractory to these treatments. Actually, there is no standard method for detection of recurrence. The purpose of this study was to evaluate the level of this enzyme in the patients with recurrent DLBCL compared to healthy controls.
Methods: In this randomized double-blind, placebo-controlled trial, the serum level of pyruvate dehydrogenase (PDH) enzyme in total of 26 patients with DLBCL recurrence in compare with 26 healthy individuals in the Sayed Al-Shohada Hospital, Isfahan University of Medical Sciences in Iran from September 2016 to September 2018, were assessed. The clinical data including age criteria, the Eastern Cooperative Oncology Group (ECOG) score rating, total bilirubin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), prothrombin time and international normalized ratio (PT/INR), CT-scan, serum creatinine, platelet count, the absolute number of neutrophils, and the interval until the last treatment were gathered. After obtaining informed consent, blood samples were taken. and the PDH enzyme was measured in case and control groups.
Results: Fifty-three percent of patients were male and the mean age of participants in case and control groups was 37.2±17.3 and 34.8±8.9, respectively. Subsequently, the PDH levels were measured according to the enzyme protocol. The levels of enzyme in patients with relapse were significantly lower than normal ones (P=0.0003). The PDH serum level was also evaluated by age and sex, which did not show any significant differences (P=0.86). 
Conclusion: In patients with relapsing B-cell lymphoma, the pyruvate dehydrogenase (PDH) enzyme serum levels were significantly lower than healthy subjects, but this difference was not related to age and gender. In the case of further studies and comparisons beyond this study, this enzyme could be a good candidate, used as an alternative diagnosis tool, in patients with recurrent lymphoma.

Identifying the factors influencing the re-admission of hospitalized patients in the internal wards of educational hospitals: a qualitative study
Leila Vali, Reza Goudarzi, Golnaz Azari, Rahil Ghorbani Nia,
Volume 78, Issue 7 (October 2020)
Abstract
Background: Currently many hospitals around the country face increasing demands of their patients and readmission.The rate of readmission is a useful indicator for determining the performance of healthcare system and it shows the quality of services in the medical institutions. Readmissions have high economic, social and financial impact and studying the related factors seems to be high priority for healthcare systems.
Methods: This qualitative study performed by phenomenological method in three educational hospitals in Kerman from April to September of 2017. Data collection was performed through semi-structured interviews using targeted sampling among all patients who were hospitalized at internal medicine wards, nurses who were working in those wards, and in charge physicians. In total twenty patients, fifteen nurses, and five physicians were selected for interviews. The including criteria were for patients, the history of hospitalization at least once, during one month after the initial hospitalization, and for service providers, familiarity with the subject, work experience in the relevant department of at least three years for nurses and five years for physicians. A seven-step clustering method was used to analyze the data.
Results: The analysis of the interviews led to the identification of three main themes and 11 sub-themes. The main themes included patients' characteristics, manpower and clinical factors, hospital, and environmental factors. Some of the sub-codes included economic and living conditions, marriage status, insurance coverage, patients' beliefs and expectations, the presence or absence of underlying disease, education, lifestyle habits, dietary beliefs of hospitalized patients, lack of trust in medical staff, communication and cultural barriers, ignorance of service providers in treatment, lack of facilities, lack of motivation in medical staff, stressors and finally lack of hospital equipment.

The role-playing autoantibodies in autoimmune thyroid diseases and their extra-thyroidal manifestations: review article
Safura Pakizehkar, Samaneh Hosseinzadeh, Majid Valizadeh, Mahdi Hedayati,
Volume 79, Issue 3 (june 2021)
Abstract
The presence of the antibodies against the main thyroid antigens, which include thyroid peroxidase (TPO) or microsomal antigen, thyroglobulin (Tg) as well as thyrotropin receptor or Thyroid Stimulating Hormone Receptor (TSH-R), is a hallmark and symbol of the autoimmune thyroid diseases (AITDs) as one of the most common autoimmune diseases (AD) around the world. The prevalence of the thyroid peroxidase antibodies (anti-TPO antibody) and the thyroglobulin antibodies (anti-Tg antibody) is considerably higher in patients suffering from Graves’ disease (GD) and Hashimoto's thyroiditis (HT, chronic autoimmune thyroiditis, autoimmune hypothyroidism). While the TSH receptor antibodies (TRAbs) are common in the patients suffering from GD, they are relatively rare and infrequent in HT patients. This fact may indicate that TRAbs are more specific than other antibodies. In fact, TRAbs as one of the most important autoantibodies against the different thyroid antigens, are a set of the heterogeneous group of antibodies that based on the function, fall into three categories, including TSHR-stimulating antibodies (TSAbs), TSHR-blocking antibodies (TBAbs), and the neutral antibodies (no effect on receptor). TSAbs and TBAbs result in overproduction and reduction of intracellular cAMP respectively. Therefore the induction of the relevant signaling pathways can be the cause of different clinical symptoms in the form of hyperthyroidism or hypothyroidism consecutively. The extra-thyroidal effects of TRAbs as the extra-thyroid GD manifestations, such as ophthalmopathy and dermopathy, often have an effect on the eyes as well as the skin with the relatively well-known immunological mechanisms of the antibodies functions. Hashimoto encephalopathy is an extra-thyroidal effects of anti-TPO that provokes the central nervous system. On the other hand, anti-TPO like anti-Tg can affect the reproductive organs of women and lead to infertility by an unknown mechanism. Moreover, the circulating antibodies against the thyroid antigens can also be detected in other autoimmune diseases such as rheumatoid arthritis (RA), type I diabetes (T1DM) and celiac disease (CD). In this review article, the most important types of thyroid autoantibodies, their essential immunological processes in AITD as well as the main and important clinical extra-thyroidal manifestations of them have been discussed and reviewed.

The effectiveness of tDCS on insomnia and mood of female with insomnia
Tahereh Motevalizadeh, Fatemeh Rezaei, Khosro Sadegh Niat Haghighi , Mohammad Ali Sepahvandi ,
Volume 81, Issue 3 (June 2023)
Abstract
Background: Insomnia is the most common sleep disorder that is associated with cortical hyperexcitability. Potentially transcranial direct current stimulation (tDCS) modifies the cortical state related to insomnia. Therefore, we hypothesized that by using tDCS the intensity of insomnia can be reduced, followed by improvement of the mood symptoms.
Methods: This study was an experimental design with a pre-test and post-test with a control group. The statistical sample included 32 females with chronic insomnia that were randomly divided into an experimental group (active stimulation) and a control group (sham stimulation). Transcranial direct current with an intensity of 2 mA was applied for 30 minutes during 12 sessions (three times in the week) in the active stimulation group. In this protocol, anodal stimulation of left Superior temporal gyrus (STG) and cathodal stimulation of right dorsolateral prefrontal cortex (DLPFC) and left secondary motor cortex (SMA). In the control group, sham stimulation was performed for 30 minutes during 12 sessions (three times in the week). The participants were evaluated before and after of the intervention using the Insomnia Severity Index (ISI) and Positive and Negative Affect Scale (PANAS).
Results: The findings of this research showed that the application of transcranial direct current stimulation was effective in reducing the severity of insomnia and improving positive and negative affect (P<0.001, F=19.87). The value of this effect (eta2) in the severity of insomnia, negative mood and positive mood is 0.64, 0.34 and 0.6 respectively.
Conclusion: The results of the present study showed that the implementation of our designed tDCS protocol for the treatment of insomnia, significantly reduced the intensity of insomnia in women with chronic insomnia and improved their mood symptoms.

Two asthma control test for children and asthma control questionnaire in pediatric asthma patients referred to taleghani hospial clinics, Gorgan
Mohsen Ebrahimi, Zahra Valipour Moghadam , Seyed Ali Aghapour, Azam Rashidbaghan,
Volume 81, Issue 7 (October 2023)
Abstract
Background: Asthma is a chronic inflammatory disease of the airways. Various tests and questionnaires are designed to monitor the severity of asthma and help the therapist and the health system prescribe the best treatment to control it. This study was designed to compare two methods Asthma Control Questionnaires (ACQ) and Asthma Control test-child (ACT-CHILD) in children with asthma.
Methods: This descriptive cross-sectional study was conducted on 92 children with asthma referred to the Taleghani hospital, Gorgan, in 2022-2023. Patients were in a range of age 4-16 years. Asthma control was evaluated and compared by two methods ACT-CHILD and ACQ. ACT-CHILD included one version for 4-11-year patients completed by their parents and another one for 12-16 –year patients completed by the patients. The clinical symptoms, age, gender and the parents' records related to asthma were completed during the clinical interview. Data was analyzed using Chi-square and Spearman correlation tests. The degree of agreement between two questionnaires was determined using the Kappa coefficient.
Results: 84 children aged 4-11 years (91.3%) and 8 children aged 12-16 years (8.7%) were included in the study. According to the ACT-CHILD, 40.2% of children (n=37) had controlled asthma, 44.6% (n=41) had partially controlled asthma, and 15.2% (n=14) had uncontrolled asthma. Based on the ACQ, controlled asthma was observed in 18.5% (n=17), partially controlled asthma in 35.8% (n=33), and uncontrolled asthma in 45.7% (n=42) of children. Asthma control results based on two questionnaires were significantly different from each other (P<0.001). The agreement between the ACT-CHILD and ACQ methods in evaluating children's asthma was at a weak level (P=0.014, κ=0.157), however, a significant negative correlation was observed between the scores of the ACT-CHILD and ACQ questionnaires (r=-0.588, P>0.001) which after categorizing based on age group, this correlation was confirmed only in children aged 4-11 years (r=-0.627, P>0.001).
Conclusion: Our findings showed that there is a poor agreement between ACT-CHILD and ACQ results in the assessment of asthma control. Further studies are recommended.

The impact of high-intensity interval training (HIIT) combined with berberine supplementation on hematological parameters in middle-aged men with pre-diabetes: a randomized controlled trial
Mehdi Nikseresht, Valiollah Dabidi Roshan , Khadijeh Nasiri,
Volume 81, Issue 10 (January 2024)
Abstract
Background: Exercise programs can lead to different physiological adaptations, but the effects of low-volume, low-frequency HIIT protocols with varying interval structures have not been thoroughly investigated. This study aimed to explore the impact of HIIT with high compression (HC) and low compression (LC), with or without berberine (BBR) supplementation, on hematological parameters in pre-diabetic men.
Methods: This semi-experimental study was conducted between October and December 2021 at Mazandaran University. Fifty-four overweight/obese men with a mean age of 48.6±6.6 years, a body mass index of 30.7±7.3 kg/m², and a body fat percentage of 34.4±4.3% were randomly and equally divided into one of six groups: HC, LC, HC+BBR, LC+BBR, BBR, and control. The HC group (2:1 work-to-rest ratio) and LC group (1:1 work-to-rest ratio) underwent training programs comprising 2-4 sets of 8 exercises at an intensity of 80-95% of their maximum heart rate twice a week for 8 weeks. Hematological responses to Bruce's incremental exercise test were measured before and after the intervention. Data were analyzed using a two-way ANOVA with Bonferroni's post hoc test, with a significance level set at P<0.05.
Results: Baseline hematological indices showed no significant differences between pre-diabetic and non-diabetic groups (all, P>0.05). Following the 8-week intervention, there were significant decreases in white blood cells (WBCs) in the LC and LC+BBR groups, and in lymphocytes across all intervention groups except BBR (all, P<0.05). Additionally, hemoglobin and hematocrit levels showed significant reductions in the HC and HC+BBR groups (both, P<0.05). However, in response to Bruce's incremental exercise test, a significant decrease in WBCs was observed in the LC and LC+BBR groups, with reductions of 18% and 25%, respectively (both, P<0.05).
Conclusion: The LC protocol, even without berberine supplementation, seems to provide better immunological benefits and result in less hemolysis compared to the HC protocol, as evidenced by reductions in white blood cell counts.

The effectiveness of intermittent Nordic exercises with and without VR on body composition and cardiorespiratory fitness in boys with internet addiction
Nima Nejati Boushehri , Valiollah Dabidi Roshan ,
Volume 81, Issue 12 (March 2024)
Abstract
Background: Being sedentary due to internet addiction is a common public health problem that causes overweight and obesity. Novel methods are needed for weight control behaviors. This study aimed to determine effects of short-term (two weeks) and moderate-term (four weeks) of virtual reality (VR) exercise program with and without interval Nordic walking (INW) in adolescent boys on novel body composition and maximal oxygen uptake (VO2max) parameters; body adiposity index (BAI), abdominal volume index (AVI), conicity index (CI), waist-to-height ratio (WHtR), and a body shape index (ABSI).
Methods: In a semi-experimental trial during July to December 2023, 70 adolescent boys (age 14.8 years, body mass index (BMI)=24.4 kg/m2 and VO2max 38 ml/kg/min) with the Young IA tests score ranging over five, were selected from the city of Karaj and randomly was classified to VR, INW, VR+INW and control groups. Individual and combined exercise programs of VR and INW were performed (three session in week for 30 min) for two and or four weeks. The parameters were evaluated at the baseline and the follow up phases (two and four weeks after the interventions period) with a repeated measure ANOVA.
Results: According to Young's internet addiction test scores at the beginning of the study, there was no significant difference between the control and intervention groups (P≥0.05). It has been observed that internet addiction negatively affects cardiorespiratory fitness. When a 2-week intervention of VR exercises was implemented along with INW, the improvement in cardiorespiratory fitness (VO2max) was better than when VR exercises alone lasted for four weeks (P≤0.05). After four weeks of INW intervention, separately and in combination with VR, a significant improvement was observed in VO2max, WHtR and BAI values compared to the control group (P≤0.01).
Conclusion: Although improvement in cardiorespiratory fitness of boys with IA can be achieved by doing short and medium term INW, VR and INW+VR exercises, longer interventions, i.e., four weeks or more, cause more significant changes in the novel body composition.

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