Yousefreza Yousefnia-Pasha; Soleiman Mahjoub; Mehdi Gholami; Mostafa Taherkhani; Ali Asghar Beyki; Maryam Gholinezhad
Volume 20, Issue 6 , 2018, Pages 1-7
Abstract
Background: Varicocele is the leading cause of male infertility throughout the world. Objectives: This study aimed to identify the effects of varicocele on oxidative stress, total antioxidant capacity (TAC), and semenparameters. Methods: In this cross-sectional study, serum and semen samples were collected ...
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Background: Varicocele is the leading cause of male infertility throughout the world. Objectives: This study aimed to identify the effects of varicocele on oxidative stress, total antioxidant capacity (TAC), and semenparameters. Methods: In this cross-sectional study, serum and semen samples were collected from subjects with no varicocele (n, 35) and pa- tients with varicocele (n, 86), who were referred to infertility and in vitro fertilization (IVF) centers of Babol Clinic Hospital, Babol, Iran during 2015 - 2016. The semen samples were analyzed according to the world health organization (WHO) guidelines. After the ultrasound and physical examinations, varicoceles were classified into three grades: G1, G2, and G3. TAC and malondialdehyde (MDA) levels were measured in the serum and seminal plasma of subjects, using the ferric reducing ability of plasma (FRAP) and thiobarbituric acid reaction (TBAR) methods, respectively. Nitric oxide (NO) was also measured using Nitric Oxide assay kit. Results: The mean total sperm count in the G1, G2, and G3 groups were significantly lower than the control group (P = 0.037; P = 0.003, and P = 0.044, respectively). A trend of lower semen volume was observed in the G3 group, compared with the control group (P = 0.06). A significant positive correlation was observed between elevated serum MDA level and varicocele degree (P < 0.05). The MDA level from the highest to the lowest is as follows: G3 > G2 > G1 > controls. There was also a significant negative correlation between the serum and seminal plasma TAC levels (P < 0.05). Varicocele patients with G3 degree had a significantly lower mean TAC level in the serum and seminal plasma, compared with the control group (P = 0.001 and P = 0.008, respectively). No significant difference was found in the mean Nitric Oxide level between the groups. However, an increasing trend for the mean Nitric Oxide level was observed in the serum and seminal plasma of varicocele patients.Conclusions: The reduced level of seminal plasma antioxidants, which is associated with increased lipid peroxidation, is one of the main reasons for low sperm quality in patients with varicocele. Antioxidant therapy may be useful in decreasing oxidative stress intensity and improving the condition of varicocele patients.
Research articles
Tahmineh Tavakoli; Toba Kazemi; Homa Mollaei; Fatemeh Salmani; Samira Saghafi; Ensiah Sadat Mousavi; Mahyar Mohamadifard; Gholamreza Sharifzadeh
Volume 20, Issue 6 , 2018, Pages 1-6
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) is one of the most frequent liver diseases worldwide. There are several com- mon risk factors between NAFLD and coronary artery disease (CAD). Objectives: This study aims to evaluate the relationship between the prevalence of Non-alcoholic fatty liver ...
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Background: Non-alcoholic fatty liver disease (NAFLD) is one of the most frequent liver diseases worldwide. There are several com- mon risk factors between NAFLD and coronary artery disease (CAD). Objectives: This study aims to evaluate the relationship between the prevalence of Non-alcoholic fatty liver disease (NAFLD) withseverity of Coronary Artery Disease (CAD) in patients undergoing coronary artery angiography. Methods: This study was a cross-sectional, descriptive-analysis research that included 514 patients who underwent angiography.The severity of CAD was assessed by the number of vessels involved (vessel score: vd). An ultrasound was performed for all the patients also, intensity of fatty liver involvement was graded from zero (absence of steatosis) to three (severe steatosis). Results: Ultrasonographic examination proven NAFLD in 59.1% of patients with different grades. Patients with NAFLD had signifi- cantly higher body mass index (P < 0.001), waist circumference (P = 0.03), and age (P < 0.001). In addition, there were significant differences between ALT and AST within the normal group and NAFLD patients (P < 0.001). Moreover, coronary angiographic data indicated that the presence of NAFLD significantly correlated with the CAD severity score as so: 64% of people with 2vd and 60.5% of people with three-vessle lisense had fatty liver that was statistically significant (df = 4; P = 0.014). Conclusions: This study showed a high prevalence of NAFLD in patients with documented CAD. It is extremely important since knowing risk factors, designing screening programs, and early treatment of fatty liver could lead to reducing the risk of cardiovas- cular diseases.
Research articles
Fariba Eslamian; Fatemeh Jahanjoo; Vahideh Toopchizadeh; Banafshe Kharrazi
Volume 20, Issue 6 , 2018, Pages 1-9
Abstract
Background: Patellofemoral pain syndrome (PFPS) is characterized by anterior knee pain due to arthralgia in the joint between the patella and femur. Many factors, including improper biomechanics and skeletal disorders, are associated with PFPS. The role of Vitamin D deficiency in the pathogenesis of ...
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Background: Patellofemoral pain syndrome (PFPS) is characterized by anterior knee pain due to arthralgia in the joint between the patella and femur. Many factors, including improper biomechanics and skeletal disorders, are associated with PFPS. The role of Vitamin D deficiency in the pathogenesis of patellar chondromalacia has been known for several years. Objectives: The aim of the present study was to determine the prevalence of Vitamin D deficiency in young people with Patellofemoral Pain Syndrome (PFPS) and compare this with the prevalence in a healthy matched control group and to determine the correlation between the occurrence of biomechanical abnormalities and serum levels of 25(OH)D in patients with PFPS. Methods: In this case-control study, 40 patients aged 15 to 40 years old with a diagnosis of PFPS, that had referred to the rehabilita- tion clinic of a university hospital in Tabriz, Iran, were selected as the case group and 40 normal subjects of the same age range were selected as the controls. Serum 25(OH)D levels were assessed, and a postural examination was performed on both groups, while the severity of knee pain, plain knee radiographs, and serum levels of calcium and phosphorous were assessed only in PFPS patients. Results: Among the 80 participants, Vitamin D deficiency (cut-off level of 25(OH)D ≤ 20 ng/mL) was observed in 55 participants (68.75%), including 35 (87.5%) patients and 20 (50%) controls, with a statistically significant difference (P < 0.001). Females had a higher prevalence of Vitamin D deficiency than males, yet the difference was not statistically significant (71.21% versus 57.14%, P = 0.348). The serum levels of Vitamin D and pain severity were significantly and inversely related in the case group (P = 0.005). Clinicaland imaging findings showed that 18 (45%) of the patients and two (5%) of the controls had abnormalities, such as genu varus, genu valgus, or patellar tracking, indicating a high coexistence of biomechanical deficits in PFPS (P < 0.001).Conclusions: Severe and moderate Vitamin D deficiencies were more prevalent in young adults with PFPS than in normal adults. Knee pain severity and joint deformities were correlated with low levels of Vitamin D in the case group. Therefore, attention to diet, vitamin supplementations, and biomechanical correction are the mainstay treatment of PFPS.
Research articles
Mohammad Kazem Emami Meybodi; Hamid Reza Rasouli; Mohammad Ghafouri; Shabnam Akhoundzadeh Bafghi; Mojtaba Ghafouri
Volume 20, Issue 6 , 2018, Pages 1-7
Abstract
Background: Osteoarthritis (OA) is a highly prevalent chronic degenerative joint disease with different risk factors, which need to be investigated in order to perform more appropriate interventions in earlier phases of Osteoarthritis.Objectives: Therefore, the aim of this study was to determine the ...
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Background: Osteoarthritis (OA) is a highly prevalent chronic degenerative joint disease with different risk factors, which need to be investigated in order to perform more appropriate interventions in earlier phases of Osteoarthritis.Objectives: Therefore, the aim of this study was to determine the correlation between hip morphology and hip Osteoarthritis. Methods: This cross-sectional study was conducted on patients aged 15 to 60 years old with hip problems, diagnosed with hip Os- teoarthritis, compared with healthy individuals as the control group. Then radiographic parameters, such as alpha angle, acetabular angle of sharp (AA), lateral center-edge angle (LCEA), femoral neck-shaft angle (FNA), coxa profunda, acetabular protrusio, crossover sign, posterior wall sign, and the ischial sign were measured by pelvic (AP) X-ray, using PACS systems in both groups. Results: This study found that alpha angle and AA were significantly greater in OA patients as compared to healthy individuals (P < 0.001). Furthermore, LCEA was significantly greater in the Osteoarthritis group on the left side as compared to the control group (38.93 ± 8.43 versus 36.81 ± 4.74, P = 0.042) yet LCEA on the right side and total amount were not different between the twogroups (P>0.05). By grouping studied angles, it was found that the frequency of alpha angle > 55°, AA > 38°, and LCEA > 40° were significantly higher in the OA group as compared to the control group (P < 0.05). Furthermore, the researchers observed that the fre- quency of acetabular protrusio (P = 0.013) and posterior wall sign were significantly higher in the OA group as compared to healthy individuals (P < 0.05). Conclusions: The current results showed that the higher Body Mass Index (BMI), greater alpha and acetabular angles, sharp, lateral center-edge angle center-edge angle, the higher rate of a posterior wall sign, and acetabular protrusio increased the risk of OA, which support that these structural changes are major contributors to OA development.
Research articles
Mehdi Mousavi; Nasrin Razavianzadeh; Mania Armin; Maryam Fadaei Dashti
Volume 20, Issue 6 , 2018, Pages 1-8
Abstract
Background: Captopril, a short-acting antihypertensive agent, is widely used in case of emergency to control blood pressure. Al- though sublingual Captopril has a faster onset of action, it is less tolerated. Objectives: This study aimed to evaluate the efficacy, side effects, and tolerability of sublingual ...
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Background: Captopril, a short-acting antihypertensive agent, is widely used in case of emergency to control blood pressure. Al- though sublingual Captopril has a faster onset of action, it is less tolerated. Objectives: This study aimed to evaluate the efficacy, side effects, and tolerability of sublingual versus oral captopril in an emer- gency setting.Methods: Hypertensive patients, without acute target organ damage were randomly administered 25 mg Captopril sublingually or orally (35 patients in each group) using block randomization. Blood pressure was measured at 0, 10, 20, 30, 45, 60, and 120 minutes after the administration. Patient satisfaction was subjectively scored on a scale of 1 - 10, and any side effect was recorded (Iranian registered clinical trials # IRCT2015110924963N1). Results: The mean age of the study groups was 59.61 ± 9.34 years. Systolic and mean blood pressure significantly decreased after10, 20, and 30 minutes of sublingual administration (P < 0.05), but diastolic blood pressure did not decrease. This difference in the blood pressure reducing effect decreased by 60 and 90 minutes and almost equalized after 90 minutes. Headache was observed as a side effect in two patients in the sublingual group. The convenience and satisfaction scores were much lower in the sublingual group (median of 6 (25th percentile: 6, 75th percentile: 7) in sublingual group versus median of 10 (9, 10) in Captopril group, P < 0.001). Conclusions: In our study, the systolic and mean blood pressure decreased more rapidly in the sublingual Captopril group than in the oral Captopril group in the first 30 minutes after administration. Patients better tolerated the oral preparation, and the difference in the blood pressure reducing effect between the groups almost equalized after 90 minutes.
Case reports
Mehrdad Karimi; Firoozeh Akbari Asbagh; Roja Rahimi; Majid Safavi; Gholamreza Pourmand; Fatemeh Sadat Hoseini; Mohammadreza Mirzaei
Volume 20, Issue 6 , 2018, Pages 1-5
Abstract
Introduction: Almost 50% of infertilities are associated with males and among them 30to 50% are idiopathic. Empirical treatments are used in idiopathic male infertility, yet not enough scientific evidence is available for the application of such remedies. Date palm pollen (DPP) is one of the drugs suggested ...
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Introduction: Almost 50% of infertilities are associated with males and among them 30to 50% are idiopathic. Empirical treatments are used in idiopathic male infertility, yet not enough scientific evidence is available for the application of such remedies. Date palm pollen (DPP) is one of the drugs suggested for such patients in Iranian traditional medicine (ITM).Case Presentation: This study was performed on a 35-year-old male patient with idiopathic infertility. He previously had severe oligoasthenoteratozoospermia and was under medical supervision at Yas hospital of the Tehran University of Medical Sciences, Tehran, Iran from August 2016 to February 2017, where he was treated with DPP at a dose of 3 g twice daily, for three months. The second semen analysis was carried out after a quarter of the treatment period, followed by re-analyses after one and three months of finalizing the treatment period. The results obtained showed an impressive improvement in the quality of semen parameters. Within six months, the initial values of normal morphology (1%), total motility (3%), progressive motility (0.0), and sperm concen- tration (0.1 million) increased to 20%, 60%, 10%, and 10 million, respectively. Conclusions: Date palm pollen could be helpful in improving semen parameters in such patients. Clinical studies are required to find the exact effect.
Research articles
Nazila Amini; Monireh Movahedi; Ali Akbar Abolfathi; Ahmad Majd
Volume 20, Issue 6 , 2018, Pages 1-6
Abstract
Background: Helicobacter pylori (H. pylori) plays the primary role in increasing oxidative stress and causing stomach inflammation, peptic ulcers, and gastric malignancy in the infected patients. L-arginine (Arg) has antibacterial and anti-inflammatory effects. Objectives: The current study aimed at ...
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Background: Helicobacter pylori (H. pylori) plays the primary role in increasing oxidative stress and causing stomach inflammation, peptic ulcers, and gastric malignancy in the infected patients. L-arginine (Arg) has antibacterial and anti-inflammatory effects. Objectives: The current study aimed at investigating the beneficial effects of L-arginine on inflammation and oxidative stress in patients infected with H. pylori with dyspeptic symptoms.Methods: The current randomized, double-blind controlled, clinical trial was conducted on 34 patients with H. pylori infection re- ferred to the center of digestive disorders affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, in order to undergo en- doscopy from December 2016 to September 2017. Patients were classified into two groups (control and treatment); the control group only received triple-drug therapy (including Amoxicillin, Clarithromycin, and Omeprazole), and the treatment group received stan- dard triple-drug therapy and L-Arg capsules for three weeks. Gastric biopsies and serum samples were taken from all patients beforeand after the study. H. pylori infection was examined by a rapid urease test and antioxidant indices including superoxide dismutase (SOD), glutathione peroxidase (GPX), and total antioxidant capacity (TAC) were evaluated in gastric biopsies. In addition, serum samples were used to measure the inflammation factors including interleukin (IL)-8 and tumor necrosis factor (TNF)-α. Results: Level of SOD activity increased significantly in the treatment group compared with that of the control group (4.91 ± 95.21 vs. 4.0 ± 44.11 IU/mg) (P = 0.001). In the treatment group, compared with the control group, the level of TAC increased significantly (0.35 ± 0.60 vs. 0.30 ± 0.9 mM/L) (P = 0.006) and the level of GPX activity increased significantly in the treatment group compared with the control group (10.68 ± 2.39 vs. 5.16 ± 2.12 IU/mg) (P = 0.000). Regarding the inflammation factor, IL-8 decreased significantly in the treatment group compared with the control group (8.00 ± 1.94 vs. 10.28 ± 2.10 pg/mL) (P = 0.002); also TNF-α decreased significantly in the treatment group compared with the control group (9.71 ± 2.69 vs. 12.24 ± 3.29 pg/mL) (P = 0.036), while therewas no significant difference in high sensitivity C-reactive protein (hs-CRP) decrease between the treatment and the control groups (2.34 ± 1.28 vs. 3.04 ± 1.58 mg/L) (P = 0.16). Conclusions: Consumption of L-arginine increased antioxidant indices and decreased inflammation in patients infected with H. pylori.
Research articles
Narjes Deyhoul; Parvaneh Vasli; Camelia Rohani; Nezhat Shakeri; Meimanat Hosseini
Volume 20, Issue 6 , 2018, Pages 1-10
Abstract
Background: Stroke is the main cause of adult inability and dependency on caregiver in performing activities of daily living (ADLs). Studies showed that the caregivers of such patients experienced high levels of dependency-induced caring pressure and, conse- quently, physical-psychological problems. ...
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Background: Stroke is the main cause of adult inability and dependency on caregiver in performing activities of daily living (ADLs). Studies showed that the caregivers of such patients experienced high levels of dependency-induced caring pressure and, conse- quently, physical-psychological problems. Objectives: The present study aimed to examine the effect of the instructional intervention on family caregivers’ perceived threat of stroke patients dependency risk.Methods: In a randomized controlled clinical trial study, a total of 45 pairs of stroke patients and their family caregivers were se- lected based on inclusion and exclusion criteria and randomly divided into the intervention and control groups. Sampling lasted from July 2016 to March 2017 and was performed in Tehran, Iran. Instructional intervention for family caregivers in the intervention group was in the form of four one-hour sessions. The data were collected before and immediately after instructional intervention at the hospital as well as two weeks and two months following the intervention via postal service. Results: The mean rank of family caregivers’ perceived threat was 1.44 and 2.76 in pre-intervention stage of intervention and control groups, which became 2.49 and 2.49 two months after intervention, respectively. The Friedman test showed that there was a signifi- cant difference in all post instructional intervention stages compared with pre-intervention (P < 0.001), whereas no such difference was observed in the control group (P = 0.245). The Mann-Whitney U test also showed that the pre-intervention family caregivers per- ceived threat was also not significantly different in the two groups (P = 0.591). However, it was increased immediately, two weeks,and two months following the intervention compared with the control group (P < 0.001). Conclusions: It is recommended that stroke patients’ caregivers be provided with instructional programs to enhance their under- standing of patient dependency risks and challenges.
Research articles
Nasir Arefkhah; Bahador Sarkari; Masood Afrashteh; Zahra Rezaei; Mona Dehghani
Volume 20, Issue 6 , 2018, Pages 1-6
Abstract
Background: Toxoplasma gondii is a zoonotic protozoan that threatens the health of the people infected with human immunodefi- ciency virus (HIV). HIV-positive subjects are at risk of cerebral toxoplasmosis. Objectives: The current study was designed to find out the seroprevalence of toxoplasmosis in ...
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Background: Toxoplasma gondii is a zoonotic protozoan that threatens the health of the people infected with human immunodefi- ciency virus (HIV). HIV-positive subjects are at risk of cerebral toxoplasmosis. Objectives: The current study was designed to find out the seroprevalence of toxoplasmosis in HIV-infected individuals in Fars province, in the South of Iran. Methods: This cross-sectional study was performed on 251 HIV-infected individuals referred to Shiraz HIV/AIDS Research Center in Fars province, Southern Iran, in 2016. Blood samples (5 mL) were collected from each individual and sera as well as buffy coat were isolated from each sample. Demographic and HIV-associated data were obtained from the patients’ medical records. Anti- Toxoplasma antibodies (both IgG and IgM) were determined by ELISA, using a commercial kit. In addition, PCR, targeting a 529 bp gene of T. gondii was performed on the patients’ buffy coats for detection of Toxoplasma DNA. Results: Anti-Toxoplasma antibodies were detected in the sera of 42 out of 251 (16.7%) HIV infected patients. Of these, 39 cases (15.5%) were seropositive only for IgG and 3 (1.2%) were positive only for IgM. Seropositive subjects mainly belonged to 40 - 49 year age group. None of the subjects were positive for Toxoplasma DNA when evaluated by the PCR. No significant associations were found between Toxoplasma seropositivity and gender, age, and CD4+ cell level (P > 0.05). Conclusions: Findings of this study demonstrated a significant rate of seroprevalence of Toxoplasma in HIV infected subjects in Fars province, Southern Iran. The seropositive cases are at risk of Toxoplasma reactivation and subsequent cerebral encephalitis. Treatment and also prevention of toxoplasmosis in HIV positive people should be considered.
Research articles
Omid Nikpayam; Hanieh Roshan; Golbon Sohrab; Meghdad Sedaghat
Volume 20, Issue 6 , 2018, Pages 1-10
Abstract
Background: Metabolic syndrome (Mets) is accompanied by oxidative stress and low-grade inflammation. Green coffee is rich in polyphenols called chlorogenic acids (CGA), which possess anti-inflammatory and anti-oxidative characteristics.Objectives: The aim of this study was to evaluate the effects of ...
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Background: Metabolic syndrome (Mets) is accompanied by oxidative stress and low-grade inflammation. Green coffee is rich in polyphenols called chlorogenic acids (CGA), which possess anti-inflammatory and anti-oxidative characteristics.Objectives: The aim of this study was to evaluate the effects of green coffee extract (GCE) on the oxidative stress as well as the sys- temic and vascular inflammation in patients having Mets. Methods: This randomized clinical trial was conducted in 2016 in Iran. Forty-three individuals (21 in the intervention and 22 inthe control group) with Mets were randomly assigned to take 400 mg GCE supplements twice a day in the intervention group or placebo capsules in the control group for 8 -weeks. The serum levels of intercellular adhesion molecule-1 (ICAM-1), interleukin-6 (IL- 6), high sensitivity C-reactive protein (hs-CRP), and malondialdehyde (MDA) were evaluated at the beginning and 8 -weeks after the intervention. Results: No significant discrepancy was observed regarding serum levels of IL-6, MDA, hs-CRP, and ICAM-1 between the intervention and control group at the beginning and the end of the trial. After eight weeks of intervention, the mean changes of IL6 in the treatment and the placebo group were respectively (-0.73 ± 2.65 VS 1.70 ± 10.51 Pg/mL, P value = 0.3), hs-CRP (-0.28 ± 3.12 VS -0.08 ± 4.15mg/L, P value = 0.86), MDA (0.44 ± 1.68 VS 0.32 ± 2.28 μmol/L, P value = 0.84), and ICAM-1 (-0.05 ± 0.45 VS 0.02 ± 0.45ng/mL, P value = 0.54).Conclusions: In this trial, the green coffee extract (GCE) administration did not affect oxidative stress, systemic, and vascular in- flammation in subjects with metabolic syndrome.
