Journal of Shahid Sadoughi University of Medical Sciences

Quadricuspid Aortic Valve: Case Report and Brief Review

Mahdi Hadadzadeh Niri — 2025-02-26

Introduction: Quadricuspid Aortic Valve (QAV) is a rare congenital heart disease characterized by four leaflets that may be of identical or varying sizes. A less common scenario includes QAV accompanied by aortic valve stenosis. Diagnosing it is difficult, and it is seen more frequently in individuals with aortic insufficiency. It estimated incidence rate of this illness ranges from 0.013% to 0.043%. Babington first reported it in 1847, and since that time, around 300 cases have been published.

This condition is occasionally associated with other congenital cardiovascular defects, with coronary artery irregularities being the most frequent. In over fifty percent of published QAV incidences, it has led to the progressive development of aortic regurgitation (AR) usually sans aortic stenosis, particularly amongst the elderly patients, frequently necessitating surgical treatment after the age of 50 We report a case of severe aortic valve insufficiency, moderate aortic valve stenosis, left main, and three-vessel coronary artery disease, thus being a candidate for aortic valve replacement and coronary artery bypass graft surgery; the case was accidentally diagnosed with QAV during surgery.

Effect of Conventional Sports Rehabilitation Compared with Psychological Interventions on Ankle Proprioception in People with Chronic Ankle Instability: A Systematic Review

Masoud Azizian — 2025-02-26

Introduction: Proprioception disorder is among significant factors to the advancement of chronic ankle instability. Consequently, this review study aimed to compare the effects of exercise and combined rehabilitation protocols on proprioception in individuals with chronic ankle instability. Methods: The present study was a systematic review conducted following the guidelines established by PRISMA. The search in this study was conducted using online databases (PubMed, Web of Science, Scapus and Science Direct) as well as the Google Scholar search engine from 2000 to the end of 2024, limited to English and Persian. The quality of the studies was evaluated using the Pedro 11-question scale.

Results: According to the inclusion and exclusion criteria, 13 studies were selected to analyze the results. Conventional sports rehabilitation protocols (6 studies) focused on balance, proprioception, and strength training. Combined rehabilitations (7 studies) included neuromuscular therapy with neurofeedback, neuromuscular therapy and vestibular training, functional training alongside hydrotherapy, and balance training combined with cognitive training focused on proprioception in individuals experiencing chronic ankle instability.

Conclusion: Combined exercises (neuromuscular and neurofeedback) and (balance and cognitive) enhance proprioception in individuals with chronic ankle instability when compared to conventional exercise routines. The psychological aspect of these patients appears to be significant in their rehabilitation process. Consequently, it is suggested that psychological protocols be used in the rehabilitation of these patients along with conventional exercise rehabilitation.

A Review of Complications and Ocular Manifestations of West Nile Virus Infection

Elham Goudarzi — 2025-02-26

Introduction: The West Nile Virus is a single-stranded RNA virus with an envelope that is part of the Flaviviridae family, and it causes diseases that can be transmitted between humans and animals. This research involved a review of around 40 articles regarding the ocular manifestations linked to the West Nile Virus, utilizing sources including Magiran, Google Scholar, SID, and others in Persian and English. Key results were gathered and showcased following assessment and comparison. . Although fever, neurological disorders, and other systemic manifestations of West Nile virus infection are the most recognized clinical signs, findings related to ocular symptoms have been studied less extensively. The most common ocular features of infection reported are non-specific scattered or linear chorioretinal lesions, anterior uveitis, retinal vasculitis, optic neuritis, and vitritis. Nystagmus, abductor nerve paralysis, optic disc edema, lack of corneal reflex, blurred vision, flying flies, redness, visual field defect and diplopia have also been reported in some cases. Ocular symptoms of West Nile virus infection typically resolve on their own.

Conclusion: The recent identification of ocular manifestations associated with West Nile infection complicates long-term prognosis for patients. Nevertheless, the majority of patients exhibiting chorioretinitis improve gradually, and their visual acuity reverts to its previous condition within several months. Therefore, the self-limiting nature of symptoms caused by West Nile virus infection is important in the differential diagnosis of cases and the adoption of the correct approach in therapeutic interventions.

Effect of Eight Weeks of Combined (Resistance - Endurance) Training and Taurine Supplementation on Protein Expression of LXR Receptors and Total Cholesterol Serum Level in Diabetic Male Wistar Rats

Ameneh PourRahim Ghouroghchi — 2025-02-26

Introduction: Liver X Receptor is a crucial gene in liver responsible for maintaining glucose and cholesterol homeostasis. Diabetes leads to disruption in LXR and total cholesterol disorder. The aim was to determine the effect of eight weeks of combined training (resistance-endurance) along with taurine supplementation on the expression of LXR receptors and serum total cholesterol in male Wistar rats.

Methods: The participants in this experimental study consisted of 50 male Wistar rats, each 6 weeks old, weighing between of 200-220 grams. To induce diabetes of 40 rats, at the end of the eighth week, the amount of 55 mg of streptozocin (STZ) per rat’s body weight was injected intraperitoneally, and the rats were randomly divided into four groups: combined exercise (n=10), taurine (n = 10), combined training and taurine (n = 10) and control (n = 10). Ten healthy rats were considered as healthy controls. The combined training group completed resistance training, which included climbing the ladder 15 times, along with endurance workouts on the treadmill at an intensity of 75% Vo2max for eight weeks, 5 times each week. The taurine group received 1% taurine supplement solution in drinking water daily. Exercise and taurine interventions were applied in the combined exercise-taurine group. Two-way ANOVA along with the LSD post hoc test was employed to compare intergroup and intragroup.

Results: After eight weeks, LXR levels decreased significantly in the supplement group (P=0.0001) and the exercise + supplementation group (P=0.0001) when compared to the control group. LXR showed a notable reduction in the exercise + supplement (P=0.0001) and supplement (P=0.011) groups when compared to the exercise group. Cholesterol levels decreased significantly in the exercise + supplement group (P=0.027) when compared to the control group. Body weight and BMI significantly were lower in the exercise, supplement and exercise + supplement groups in comparison to the control group. Although it was significantly higher in the exercise group when compared to the supplement and exercise + supplement groups (P<0.05).

Conclusion: Eight weeks of combined (resistance-endurance) training and taurine consumption decreased LXR, body weight, BMI and total cholesterol in diabetic rats.

Effectiveness of a Period High Intensity Interval Training and Bee Pollen Consumption on the Level of Tropomyosin Receptor Kinase B in Hippocampus Rats Exposed to Cadmium

Sam Rahmani Chegani — 2025-02-26

Introduction: The present study investigated the effectiveness of high-intensity interval training (HIIT) and pollen (PO) on tyrosine kinase receptor B (TRKb) in mice exposed to cadmium. Studies have shown that cadmium causes a decrease in BDNF and inactivation of TRKb.

Methods: 25 male Sprague-Dawley mice were selected at the age of 8 weeks, and were randomly replaced in five groups of five, which included the healthy control group (HC), the cadmium control group CD), cadmium + pollen group (PO), cadmium group + intense intermittent exercise (HIIT), cadmium + pollen group + intense intermittent exercise (HIIT-PO) group. Cadmium was administered as cadmium chloride 400 mg/kg.l dissolved in water to all groups except the healthy control. Daily, 200 mg of flower pollen in 2.4 cc of normal saline was given by gavage to groups (PO/HIIT-PO). To determine the maximum intensity of exercise, the standard Bedford incremental test was used for the HIIT-PO and HIIT groups. 48 hours after the final training session and supplementation, the mice were anesthetized using ketamine (50 mg/kg) and xylosine (20 mg/kg) after a 12-hour fasting period. The hippocampus of the brain was extracted and the data were analyzed using independent T-test and two-way ANOVA with SPSS 16 software.

Results: Cadmium significantly decreased TRKb (P≤0.05), HIIT training and pollen supplementation significantly increased TRKb, and the interaction effect of HIIT training and pollen supplementation was also significant (P≤0.05).

Conclusion: It is possible that the antioxidant effects of pollen can increase TRKb levels, HIIT training increases the concentration of hydrogen peroxide (H2O2) and tumor necrosis factor alpha (TNF-α) in the brain, which can facilitate the synthesis of BDNF and therefore increase TRKb levels.

Studying the Effect of 12 Weeks of Resistance Training with Sumac Supplementation on Inflammatory and Apoptotic Indices in Male Alzheimer's Mice

Akbar Yeganeh Hashemi — 2025-02-26

Introduction: Alzheimer's disease represents the most prevalent form of dementia, characterized by a gradual decline in memory function. This study aimed to examine the impact of 12 weeks of resistance training combined with sumac supplementation on various inflammatory and apoptotic markers in the serum of male rats exhibiting Alzheimer's disease.

Methods: In this experimental study, 35 rats were randomly divided into five groups: control, Alzheimer's, Alzheimer's + sumac supplement, Alzheimer's + resistance training, and Alzheimer's + resistance training + sumac supplement. To induce Alzheimer's, 8 mg/kg of trimethyltin chloride was administered to the rats along with 200μl of normal saline. Sumac was added to the food of the subjects at a rate of 10% and was freely available to them. Resistance training was performed for 12 weeks, five times a week, in the form of climbing a ladder with weights attached to their tails, one meter long, with 26 steps and an angle of 85 degrees. Then, the rats were sacrificed and blood samples were taken. IL-18 and Cas3 were examined using the ELISA method. IL-18 and Cas3 were examined using ELISA. The data results were analyzed using one-way ANOVA with Tukey's post hoc test at a significance level (p<0.0001) using SPSS software version 16.

Results: The findings indicated that a period of resistance training along with sumac supplementation significantly reduced the levels of interleukin 18 and caspase 3 (p<0.0001). However, sumac supplementation alone, as well as resistance training alone, significantly reduced the expression of caspase 3 protein (p<0.0001), but had no significant effect on the levels of interleukin 18 (p<0.05).

Conclusion: Our findings showed that resistance training combined with sumac supplementation can improve the levels of inflammatory and apoptotic indices.

Effectiveness of Transcranial Direct Current Stimulation (Tdcs) on Pain Intensity, Anxiety and Depression in Patients with Rheumatoid Arthritis

Maryam Sadeqpur — 2025-02-26

Introduction: Rheumatoid arthritis is a chronic autoimmune disease characterized by joint synovitis and damage to the surrounding cartilage and soft tissues. In this study, it was assumed that stimulation of the prefrontal cortex (DLPFC) by transcranial direct current stimulation (tDCS) has reduced pain intensity in the rheumatoid arthritis patients and improved anxiety and depression outcomes.

Methods: The current research was a semi-experimental design that involved a pre-test, post-test and a one-month follow-up with a control group The statistical population included all men and women diagnosed with rheumatoid arthritis who referred to the Rheumatology Department of Tehran's Family and Shariati Hospitals in 2024. A total of thirty individuals were selected through available sampling and then randomly assigned to either the experimental and control groups. Anodal tDCS was applied to stimulate the left dorsolateral prefrontal cortex (DLPFC), while cathodal tDCS was employed to inhibit the right DLPFC. Participants were assessed before-after and in the one-month follow-up period using the McGill Chronic Pain Index, and the Beck Depression and Anxiety Scale. Data analysis was conducted utilizing repeated measures analysis of variance and was performed with SPSS-16.

Results: The findings showed that transcranial direct current stimulation (tDCS) significantly reduced pain and anxiety levels in both the post-test and one-month follow-up, with P-values less than 0.05. Regarding depression, the post-test results were also significant (p<0.05), but in the one-month follow-up, this effect was no longer significant (p>0.05). In contrast, the control group exhibited little variation across all three phases.

Conclusion: The results show that tDCS has a greater effect in reducing pain, anxiety and depression symptoms compared to placebo and is able to reduce inflammation and improve the quality of life of volunteers through prompt medical care and more compliance with treatment orders to reduce disease activity or even reach the recovery is complete.

The effect of S-ketamine administration on improving memory and learning following cerebral ischemia and reperfusion in male Wistar rats

Seyedeh Mahdieh Khoshnazar — 2025-02-26

Introduction: This study investigated the effect of S-ketamine administration as a neuroprotective treatment for necrotic cell death and memory and learning impairments following a cerebral ischemia model in male rats.

Methods: In this experimental study, 28 male Wistar rats with weighing between 250-300 g, were randomly divided into four groups: Sham, Ischemia-Saline, Ischemia-S-ketamine (low dose), and Ischemia-S-ketamine (high dose).In the ischemia groups receiving low and high doses of S-ketamine, the drug was administered immediately right after the onset of ischemia at doses of 0.1 mg/kg and 0.25 mg/kg body weight, respectively. Memory and learning were evaluated in the different groups through the passive avoidance learning test. Four days after induction of ischemia, necrotic cell death was measured using Cresyl violet staining. Data were analyzed using SPSS software.

Results: The results showed that in the ischemia-saline group, significantly increased in the number of necrotic cells compared to the sham group (p<0.05). Treatment with S-ketamine substantially decreased necrotic cell death in the CA1 region of the hippocampus. The reduction in ischemia-induced cell death was more significant in the high-dose S-ketamine treatment group compared to the low-dose S-ketamine treatment group (p<0.05). Moreover, S-ketamine treatment improved memory and learning deficits caused by ischemia in a dose-dependent manner.

Conclusion: Treatment with S-ketamine has been able to affect the consequences of cerebral ischemia, and therefore the introduction of S-ketamine therapy is proposed as a new therapeutic method in the treatment of cerebral ischemia.