---

Background and aim:  Polycystic ovary syndrome is a common endocrine disorder that is associated with lipid disorders and obesity with an increased risk of cardiovascular disease. The aim of this study was to determine the association between lipid profile and fasting blood sugar levels and insulin resistance among women with polycystic ovary syndrome.

Methods: The present case-control study was conducted on 153 women with PCOS and 449 healthy women as controls. Data was extracted from data center of Diabetes Research Center of Ahvaz University of Medical Sciences including women from 4 cities of Khuzestan province (Ahwaz, Behbahan, Abadan, and Khorramshahr). Serum lipids, fasting blood sugar, and serum insulin levels along with Body Mass Index (BMI), Homeostatic Model Assessment Insulin Resistance (HOMA IR), Lipid Accumulation Product (LAP), and Body Adiposity Index in two groups were analyzed by independent t-tests, chi-square and Fisher exact test.

Results:  The frequency of low HDL and high total cholesterol was higher in women with PCOS than control group (p =0.032, and p =0.001, respectively). No significant difference was seen between No two groups in the mean levels of total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol, fasting blood sugar, HOMA IR, LAP, and PA (p >0.05). In women with BMI<25 and BMI between 25 and 30, the mean level of total cholesterol was higher in PCOS group than control group, whereas there was no significant difference in women with BMI>30. In women with BMI>30, the mean triglyceride and glucose levels was higher in PCOS group than control group (p=0.029, and p=0.010).

Conclusion:  In the present study, in obese women, triglyceride and fasting glucose levels were higher in patients with polycystic ovary syndrome than healthy women. In non-obese women, however, the total cholesterol level was higher in patients with polycystic ovary syndrome than healthy women.

 

---

Abstract:
 
Background and Aim:  Zinc phosphate is a solid gray chemical compound whose commercial sample is dark or even black and white. Severe hypertension and cardiac poisoning are the most serious complications of zinc phosphate poisoning and are associated with a high mortality rate. Poisoning with zinc phosphide as a rat poison, which has similar effects to aluminum phosphide tabletsis is uncommon. The report relates to a death case following poisoning with zinc phosphide mice.
 
Case Report: The patient was a young 18-year-old man who was admitted to suicide attempted at hospital. Due to the lack of toxic poison, the patient was treated with supravavalin as probable toxicity. After several hours of admission, his level of consciousness was reduced with deep breathing. In the tests after the onset of shortness of breath, pH was 6.94, HCO3: 4.9, blood sugar 21, creatinine 6.1 and BUN: 24. Then, the zinc phosphate was detected. Despite the onset of treatment, after 1 hour, the patient suffered from cardiopulmonary arrest and eventually died.
 
Conclusion: Poisoning with zinc phosphide can cause acute renal failure. Considering that phosphide is one of the poisonous toxins of rodents, especially in rat poison, toxic poisoning with phosphodies is also recommended in poisonous toxin poisoning cases.
 
 

---

Background & aim: Acute rheumatic fever is an autoimmune disease that mainly affects the large joints. Early treatment of a throat infection following group A streptococcus prevents of acute rheumatic fever. Given the low prevalence of the disease, especially in a situation where there is excessive use of antibiotics in Iran, this study intends to report a patient with acute rheumatic fever with mild criteria.
 
Case report: the patient was a 14-year-old male that came to the internal medicine clinic due to weakness and joint pain. The patient had pain in the joints of the wrists and ankles, as well as the knees which was migratory in the patient. He had a history of fever and sore throat a month before the visit. The patient did not describe the skin lesion. On examination, the patient had vital signs of BP: 100/60 mmhg, PR: 90 / min, RR: 25, and T: 37.7. The throat examination was slightly erythematous, and without exudates, the cardiac examination was tachycardia without murmur. On examination of the joints, only the left knee joint had redness, and it was warm to the touch. In the laboratory tests, ASO: 400, ESR: 94 and CRP: 76 were. The patient's chest x ray, ECG, and echocardiogram were normal. Based on the symptoms and laboratory tests in Jones criteria, the diagnosis of ARF was confirmed. Then, the initial treatment, naproxen and co-amoxiclav was started, and explained for the patient to receive injection of penicillin benzathine once a month until the age of 21.
 
Conclusion: Acute rheumatic fever should be considered as part of the differential diagnosis of polyarthritis in the young patients, so that, if present, with appropriate treatment and prophylaxis, we can to able reduce the social costs from rheumatic heart disease.
 
 

---

Background & aim: Considering that overweight and obesity in transplant patients are considered as a risk factor for the occurrence of metabolic disorders, heart diseases and reduced kidney function, therefore, the purpose of the present study was to determine and investigate the relationship between anthropometric indicators and kidney function. In addition, the serum levels of fibroblast growth factor-23 and matrix gamma carboxyglutamate protein were markers of cardiovascular disease risk in kidney transplant patients.

Methods: The present study was conducted as a cross-sectional study in 2016-2019. Ninety kidney transplant patients referred to Tabriz Imam Reza (AS) hospital clinic, between 18 and 70 years of age and had normal kidney function and were within 6-12 months after transplant, were selected. Weight, height, waist circumference, body mass index and ratio of waist circumference to height were measured. Serum levels of fibroblast growth factor-23 and dephosphorylated and non-carboxylated protein matrix gamma carboxyglutamate were measured and glomerular filtration rate was calculated as an index of kidney function. Collected data were analyzed using Kolmogorov-Smirnov, Pearson and Spearman statistical tests.

Results: The mean and standard deviation of the age of the subjects was 44.10±13.05 years and 59% of the patients were male. Mean ± standard deviation of weight, body mass index, waist circumference and ratio of waist circumference to height of the patients were 69.61±11.59 kg, 25.77±4.42 kg/m2, 94.07±15.48 cm and respectively. It was 0.58±0.11. The prevalence of overweight and obesity based on body mass index was 38% and 17%, respectively. The mean ± standard deviation of the glomerular filtration rate is 57.45±12.61 ml/min per 1.73 square meter and the serum level of fibroblast growth factor-23 is 73.63±20.9 units/ml and the median (25th percentile) and the 75th percentile) the dephosphorylated and non-carboxylated protein gamma carboxy glutamate matrix of serum was also (1.3, 60.20) 2.40 micrograms/liter. Significant correlation between anthropometric indices with glomerular filtration rate and serum levels of fibroblast growth factor-23 and matrix gamma carboxy glutamate dephosphorylated and non-carboxylated protein, as well as between glomerular filtration rate and serum levels of fibroblast growth factor-23 and matrix gamma carboxy glutamate dephosphorylated protein and Non-carboxylated was not observed (p>0.05). A significant inverse correlation was observed between serum levels of fibroblast growth factor-23 and dephosphorylated and non-carboxylated protein gamma-carboxyglutamate matrix (p=0.036).

Conclusion: Considering that in the present study, the average weight, body mass index and also the performance of all patients were almost within the normal range, therefore, there is a significant relationship between anthropometric indices with glomerular filtration rate and serum levels of fibroblast growth factor-23 and gamma carboxy matrix. Dephosphorylated and non-carboxylated protein glutamate was not observed.

 

---

Background & aim: Covid-19 is an emergent virus which has infected millions of people and triggered a serious circumstance all over the world. Due to the high prevalence of Covid-19 and limited treatment capacity, quick identification of factors which indicate the severity of the disease can be very helpful. The purpose of the present study was to determine and investigate the relationship between C-reactive protein and lymphopenia with the severity of the disease in hospitalized patients with Covid-19 in Yasuj, Iran, in 2019.

Methods: The present descriptive study was of retrospective type and available sampling method was used in 2019 on 206 patients with covid-19 where blood oxygen level, CT scan and CRP and blood lymphocyte levels were the main factors investigated. The sampling method was census and using a predetermined checklist, the required information was extracted from the files of patients admitted to the hospital. In this study, the background information of the patients including age, gender, clinical symptoms, length of stay in the hospital, the patient's condition based on discharge with relative recovery or death were collected. Furthermore, paraclinical information including: percentage of blood oxygen saturation, white blood cell count, lymphocyte, CRP and lung involvement in CT scan were extracted from the patients' files. The collected data were analyzed using the Willicion test and one-way analysis of variance.

Results: The participants in the present study included 206 people whose average age was 51.39 years. 103 (50%) were men and 103 (50%) were women. The results of one-way analysis of variance indicated that there was a significant difference in the amount of lymphocytes in patients with severe, moderate and mild disease based on the oxygen level (p=0.03), but the CRP level in these patients was based on the blood oxygen level (p=0.32).  CT scan (p=0.07) did not show any significant difference. In addition, there was no significant difference in the amount of lymphocytes in patients with severe, moderate and mild corona based on CT scan (p=0.14).

Conclusion: According to the findings obtained from the present study, it appeared that the level of lymphopenia can be used to predict the severity of the disease in patients with covid-19, but the level of CRP can be used to predict the severity of the disease in Covid-19 patients cannot be used based on the obtained results.

---

Background & aim: The medical staff involved in the fight against the Covid-19 disease experience high physical and mental pressures. In this regard, it is necessary to investigate the psychological symptoms of healthcare workers at risk and compare them with other populations. Therefore, the present study was conducted with the aim of comparing psychological symptoms in the medical staff of specialized medical centers with the medical staff of non-specific Corona centers.
Methods: This is a descriptive cross-sectional study of a comparative type that was conducted from August to December 2021. The statistical population was all the medical staff of specific and non-specific Corona medical centers of hospitals in Kohgiluyeh and Boyer Ahmed state in 2021. 169 of them were selected using the available sampling method. Questionnaires for demographic information, patient health (PHQ-9), generalized anxiety (GAD-7), and Pittsburgh sleep quality (PSQI) was used. SPSS-25 statistical software, descriptive indices, independent t-test, and chi-square (chi-square) test were used for data analysis. 
Results: 97 people (57.40%) of the participants were in special medical centers for Corona and 72 people (42.60%) were in non-specific medical centers for Corona. There was a significant difference between the research groups in terms of the participant infected with Corona (P<0.05). Also, there was a significant difference between the research groups in terms of anxiety (P<0.05), but there was no significant difference between them in terms of depression and sleep quality (P<0.05).
Conclusion: Considering the high anxiety of the frontline medical staff, it is necessary to design and implement trainings and interventions based on anxiety reduction for them.
 

---

Background & aim: Colonoscopy is the main method of colon examination. Acceptable bowel preparation plays an effective role in examining the bowel. Diagnosis and treatment of colon polyps or non-bulging lesions such as vascular malformations and serrated polyps depend on the degree of intestinal cleanliness at the time of assessment. On the other hand, insufficient preparation makes the evaluation more difficult, the evaluation is incomplete, increases the time of colonoscopy and the need to repeat the procedure, and this increases the cost. Therefore, the purpose of the present study was to determine and prepare the large intestine for colonoscopy with pidrolox produced in Iran with and without Senagraf syrup in two centers affiliated to Shiraz University of Medical Sciences.

Methods: In the present prospective, double-blind descriptive study conducted in 2016 on 273 patients in need of non-emergency colonoscopy referred to Shahid Motahari and Shahid Faqihi clinics of Shiraz, Iran, 227 patients were randomly selected into two drug (111) and control groups. (116) were categorized and studied. The effect of adding Senagraf to pidrolox manufactured in Iran with pidrolox along with placebo on the level of intestinal readiness (based on Ottawa scoring) in eligible patients (20-78 years old) who were willing to enter the study was investigated and compared. Collected data were analyzed using Mann-Whitney, Kruskal-Wallis and Chi-square statistical tests.

Results: The average score of intestinal cleanliness in whole and as well by different parts, in the drug group, was lower than the control group, which confirms better preparation (p=0.001). Compared to older people, younger people had cleaner intestines (p=0.001). The level of bowel preparation in female patients was also better than male patients (p=0.001). The travel time from the rectum to the cecum and the return time from the cecum to the rectum were significantly less than the control group (p=0.001). No significant side effects were observed in both groups.
 
Conclusion: Adding senna to Iranian polyethylene glycol (PEG) before colonoscopy increased bowel preparation and reduces colonoscopy time, without causing additional side effects.

 

---

Background & aim: Oak placenta(Jaft) extract has potent antioxidant, anti-proliferative, anti-cancer activity, and other therapeutic properties. Therefore, the aim of this study is to investigate the effect of Jaft extract and its combination with Cisplatin on gastric cancer adenocarcinoma cell line (AGS).

Methods: In the present experimental study conducted at Shahid Chamran University of Ahvaz in 2022, the AGS cell line was cultured in 1640-RPMI medium and treated with Jaft extract and cisplatin. Cell viability and combination index(CI) were measured using the MTT assay and Compucyn software(respectively). Moreover, the expression of the CDK2 gene as an important gene involved in the cell cycle was evaluated by Real-Time PCR. The collected data were analyzed using Graph Pad Prism 6 software and one-way ANOVA.

Results: The findings of the present study indicated that Jaft extract and cisplatin cause decreased cell viability of AGS (p< 0.0001). The analysis of compusyn data indicated that these two substances together have synergistic properties (CI<1), in addition to simultaneous usage of Jaft extract increases the cytotoxicity of cisplatin drug. In the simultaneous treatment, it was observed that the expression of CDK2 decreased and led to an increase in the anticancer effect of cisplatin (p<0.001).

Conclusion: The present study revealed that placenta extract had anti-proliferative and anti-cancer properties. According to the synergistic effects of these two drugs, Jaft can change the gene expression of CDK2 in the cell cycle and introduce a possible approach for the treatment of gastric cancer with more potency and less dose of administered cisplatin to induce toxicity. The results of the present study indicated that Jaft extract is a proper selection to sensitize cancer cells to cisplatin.

 

---

Background & aim: Diabetes is one of the five common chronic diseases all over the world, which can cause many complications if not treated and controlled. Mental health is an important factor against diseases that can even lead to improvement of physical health in people. The anxiety caused by the coronavirus has led to the fact that the mental health of people with underlying diseases such as diabetes is at risk, and their physical health is also affected by it. Considering the spread of the coronavirus epidemic, the purpose of the present study was to compare the anxiety and depression of patients with diabetes with average individuals during the spread of the coronavirus epidemic.

Methods: The present descriptive-analytical and comparative causal study included 300 people (150 diabetic patients, 150 normal people) who were selected by purposive sampling. The data of the present study was collected electronically using a 9-question patient health questionnaire and a 7-question general anxiety questionnaire. The collected data were analyzed using Klomogrov-Smirnov, independent t, t-test and chi-square statistical tests.

Results: In the present study, the average age of the participants was 27.48 years. Moreover, 191 female participants and 109 male participants, and the majority were university educated and married. The special findings of the study indicated that patients with diabetes experienced higher anxiety (t₂₉₈=3.15, p<0.05) and depression (t₂₉₈=2.23, p<0.05) than average individuals during the outbreak of corona disease and a statistically significant difference was observed between the two groups in the analysis of these two variables.

Conclusion: The results obtained from the present study indicated that the high level of anxiety and depression during the outbreak of the Corona epidemic made patients with diabetes more vulnerable to psychological problems.

 

---

Background & aim: Restless legs syndrome (RLS) is characterized by an uncomfortable urge to move the legs while at rest, relief upon movement or getting up to walk, and worsened symptom severity at night. Studies show that diabetic patients are at high risk of developing RLS and Studies have indicated a high risk of RLS development in diabetic patients, with an established association between RLS and diabetes. RLS has not been investigated in prediabetic patients; Therefore, the aim of the present study was to investigate RLS in prediabetic patients and its relationship with sleep quality, to help improvement of the patient's symptoms and blood sugar control by identifying sleep disorders related to RLS and managing it.


Methods: The present cross-sectional study was conducted on 166 patients meeting inclusion criteria in Yasuj, Iran in 2023. Participants completed the International Restless Legs Syndrome (IRLS) and Pittsburgh Sleep Quality Index (PSQI) questionnaires administered by the researcher. Data analysis was performed using descriptive and analytical statistics through the SPSS software


Results: The mean age of the patients in the present study was 46.23 ± 11.68 years and ranged from 21 to 75 years. 96 (57.8%) were women and 70 (42.2%) were men. The average of RLS score in the examined patients was 6.54 ± 3.05 and ranged from 0 to 35. It was also shown that 68.07% had no symptoms of RLS. Therefore, the prevalence of RLS in pre-diabetic patients was 31.93%. Gender did not significantly affect RLS scores (P=0.951) and there was no significant difference in the severity of RLS between men and women (P=0.097). The mean of the sleep quality score in the investigated patients was 6.25 ± 4.00 and ranged from 0 to 17. It was also shown that 41% had sleep disorders and there was no significant difference between score of sleep quality in men and women (P=0.168). There was no significant difference between men and women having or not having sleep disorders (P=0.240). The results showed that there was a significant and positive relationship between the severity of RLS and sleep disorder. (P

Conclusion: The results of the study indicated a direct and significant relationship between RLS and sleep quality disorders in prediabetic patients.

---

Background & aim: Psychosocial factors are crucial for patients with coronary artery disease (CAD), but the type and outcome of anxiety disorders in these patients have not been studied as much as other risk factors. Therefore, the aim of the present study was to determine and investigate psychometric indicators of generalized anxiety disorder (GAD) in CAD patients.

Methods: The present research applied a descriptive-cross-sectional method. The statistical population included all patients with CAD referred to Golestan Hospital in Ahvaz, Iran,in 2022. Two-hundred and nine participants were selected using available sampling method and completed the 7-item scale of generalized anxiety disorder (GAD-7). The collected data were analyzed using Cronbach's alpha, Pearson's correlation coefficient, independent t test, one-way analysis of variance, exploratory factor analysis and Imus.

Results: The mean and standard deviation of age for men was 58.47±10.45 and for women it was 62.40±9.47. 152 people (72.73%) were men, Cronbach's alpha was equal to 0.936 and a one-factor model was obtained using exploratory factor analysis (EFA). Confirmatory factor analysis (CFA) indicated that the modified one-factor model of GAD-7 (this factor is named GAD-7) had a good fit.

Conclusion: since CAD patients experience high anxiety, it is important to use a short and valid tool to determine their anxiety. Therefore, GAD-7 has worthy psychometric properties for use in patients with CAD.