Journal of Gorgan University of Medical Sciences

Effects of Crocin on Oxidative Stress and Inflammatory Markers in Lipopolysaccharide-Induced Acute Kidney Injury in Male C57BL/6 Mice

Mehrdad Roghani

Background and Objective: At high doses, lipopolysaccharide (LPS) acts as an endotoxin and induces acute kidney injury (AKI) in rodents. Crocin, a carotenoid and one of the active constituents of saffron, has numerous pharmacological properties, including antioxidant and anti-inflammatory activities. This study aimed to determine the effects of crocin on oxidative stress and inflammatory markers in LPS-induced AKI in male C57BL/6 mice.
Methods: This experimental study was conducted on 24 male C57BL/6 mice weighing 19-23 g and aged 8-10 weeks at the Experimental Studies Laboratory of Shahed University. The animals were randomly assigned to four groups of six: control, LPS, LPS plus crocin at 10 mg/kg body weight, and LPS plus crocin at 50 mg/kg body weight. In the treatment groups, crocin at 10 or 50 mg/kg body weight, dissolved in Califor vehicle, was administered by gavage twice at a 24-hour interval, with the second dose given one hour before LPS injection. To induce AKI, LPS dissolved in normal saline (10 mg/kg body weight) was injected intraperitoneally one hour after the final crocin dose. Biomarkers of renal function and oxidative stress, as well as inflammatory and anti-inflammatory factors, were evaluated.
Results: Compared with the LPS group, treatment with crocin at 50 mg/kg body weight significantly reduced serum creatinine (0.54±0.05; P<0.01) and BUN (25.80±2.40; P<0.05). The renal oxidative-stress marker MDA (2.75±0.22) also decreased significantly, whereas SOD activity (5.75±0.36) increased significantly (P<0.05). Crocin treatment also significantly reduced TNF-α (41.80±3.50; P<0.01) and increased IL-10 (52.90±3.30; P<0.05) compared with the LPS group.
Conclusion: Crocin may prevent LPS-induced AKI by suppressing oxidative stress and inflammatory mediators in renal tissue.

Effects of Intermittent Leg Blood-Flow Occlusion and Aerobic Exercise on Cardiac Mitochondrial Dynamics in a Rat Model of Myocardial Infarction

Amin Farzaneh Hesari

Background and Objective: Cardiac mitochondrial dysfunction is well recognized in ischemic heart disease, and mitochondria appear to play an important role in the exercise-induced cardioprotective effects observed after myocardial infarction. Brief, intermittent periods of blood-flow occlusion protect the heart from injury; however, the underlying mechanism remains unclear. This study aimed to determine the effects of intermittent leg blood-flow occlusion and aerobic exercise on cardiac mitochondrial dynamics in a rat model of myocardial infarction.
Methods: This experimental study included 25 male Wistar rats aged 8-10 weeks and was conducted at the Histogenotech Laboratory Animal Breeding and Maintenance Center in Tehran. The animals were divided into five groups of five: healthy control, myocardial infarction, myocardial infarction plus occlusion, myocardial infarction plus exercise, and myocardial infarction plus exercise and occlusion. Myocardial infarction was induced by two intraperitoneal doses of isoproterenol (100 mg/kg.day). Intermittent leg blood-flow occlusion comprised three cycles of 5-minute occlusion followed by 5-minute reperfusion. Aerobic exercise was performed five days per week for six weeks. MFN1 and Drp1 gene expression was measured using real-time PCR.
Results: Compared with the healthy group, myocardial infarction was associated with decreased cardiac MFN1 expression (0.120±0.013 vs 1.003±0.095) and increased Drp1 expression (4.937±0.209 vs 1.011±0.184) (P<0.05). Compared with the myocardial infarction group, MFN1 increased and Drp1 decreased significantly in the occlusion (MFN1=0.298±0.028; Drp1=3.99±0.136), exercise (MFN1=0.409±0.010; Drp1=3.57±0.432), and exercise-plus-occlusion groups (MFN1=0.659±0.027; Drp1=1.765±0.022; P<0.05).
Conclusion: Aerobic exercise and intermittent leg blood-flow occlusion improve cardiac mitochondrial dynamics by regulating mitochondrial fission and fusion in male rats with myocardial infarction. Combining aerobic exercise with intermittent blood-flow occlusion produces a greater effect.

Effects of Six Weeks of High-Intensity Interval Training Combined with L-Arginine Supplementation on Interleukin-6, Interleukin-10, and Liver Enzyme Levels in Soccer Players: A Clinical Trial

Keyvan Hejazi

Background and Objective: High-intensity interval training is highly effective for improving athletic performance. However, the substantial mechanical and metabolic stress associated with this training may cause considerable post-exercise inflammation and transient biochemical disturbances. This study aimed to compare the effects of six weeks of high-intensity interval training combined with L-arginine supplementation on interleukin-6, interleukin-10, and liver enzyme levels in soccer players.
Methods: This clinical trial included 20 volunteer semiprofessional soccer players in Mashhad during 2025. Participants were allocated by simple randomization to either an exercise-plus-supplement group or an exercise-plus-placebo group. The six-week intervention consisted of three high-intensity interval-training sessions per week. Blood samples were collected at two time points (pretest and posttest), both at 8:00 a.m. after a 12-hour fast. Cytokine concentrations were measured by enzyme-linked immunosorbent assay, and the liver enzymes ALT and AST were measured using standard photometric methods and an autoanalyzer.
Results: At posttest, the exercise-plus-supplement group showed a statistically significant increase in interleukin-10 and a statistically significant decrease in alanine aminotransferase compared with the placebo group (P<0.05). Within-group comparisons showed a statistically significant reduction in interleukin-6 in the exercise-plus-supplement group (P<0.05), whereas no significant change occurred in the exercise-plus-placebo group. Interleukin-10 increased significantly by the end of the intervention in the exercise-plus-supplement group (P<0.05), but did not change significantly in the exercise-plus-placebo group. Aspartate aminotransferase and alanine aminotransferase decreased significantly in the exercise-plus-supplement group (P<0.05), whereas neither enzyme changed significantly in the exercise-plus-placebo group.
Conclusion: Exercise combined with L-arginine supplementation significantly increases interleukin-10 and reduces interleukin-6 and liver enzyme levels.

Effect of a Fatigue Protocol on the Frequency Spectrum of Ground Reaction Forces during Running in Men with Pronated Feet Following Anterior Cruciate Ligament Reconstruction: A Clinical Trial

Amir Ali Jafarnezhadgero

Background and Objective: Anterior cruciate ligament rupture is among the most common sports injuries and has substantial consequences for function, return to sport, and knee-joint health. This study aimed to determine the effect of a fatigue protocol on the frequency spectrum of ground reaction forces during running in men with pronated feet following anterior cruciate ligament reconstruction.
Methods: This clinical trial was conducted at the University of Mohaghegh Ardabili and included 15 men with pronated feet who had undergone anterior cruciate ligament reconstruction and 15 healthy men. Participants in the intervention group had undergone unilateral anterior cruciate ligament reconstruction using a hamstring autograft 4-8 months before the study. Participants first ran along an 18-m track while ground reaction forces were recorded using a force plate positioned at the midpoint. After completing the fatigue protocol, ground reaction force data were recorded again during running.
Results: Changes in the 99.5% power frequency of the mediolateral (2.72±2.31) and anteroposterior (2.35±1.11) ground reaction force components were greater in the intervention group than in the healthy group (-1.24±2.96 and -1.42±4.17, respectively; P<0.05). Within-group analysis showed that the 99.5% power frequency values for the mediolateral ground reaction force component after fatigue in the anterior cruciate ligament reconstruction group with pronated feet (16.16±1.75 and 12.00±1.98, respectively) were higher than the corresponding values before fatigue (13.85±2.36 and 10.16±2.26, respectively) (P<0.05).
Conclusion: Fatigue may affect balance control, particularly in individuals who have undergone anterior cruciate ligament reconstruction. Reduced balance may also decrease running speed.

Association between the Cyclooxygenase-2 Gene Polymorphism (-765G>C) and Serum Prostaglandin E2 Levels in Patients with Type 2 Diabetes

Safoura Khajeniazi

Background and Objective: Cyclooxygenase-2 (COX-2) is a proinflammatory enzyme whose principal product, prostaglandin E2 (PGE2), may contribute to the development of type 2 diabetes. Genetic polymorphisms are among the factors that can influence COX-2 activity or expression. This study aimed to evaluate the association between the COX-2 gene polymorphism (-765G>C) and serum PGE2 levels in patients with type 2 diabetes.
Methods: This case-control study included 50 patients with type 2 diabetes and 50 healthy individuals attending Shahid Sayyad Shirazi Teaching Hospital in Gorgan, Iran. Serum FBS, HbA1c, and PGE2 levels were measured using ELISA kits, and the gene polymorphism was determined by ARMS-PCR.
Results: The COX-2 -765G>C polymorphism was not significantly associated with either diabetes or PGE2. PGE2 levels were higher in patients with diabetes (43.42±31.2) than in healthy controls (17.67±6.38; P<0.05). PGE2 levels were significantly higher in individuals with the CG genotype (41.15±30.99) than in those with other genotypes (P<0.05).
Conclusion: The COX-2 -765G>C polymorphism, as an inflammatory mediator-related variant, had no effect on the risk of diabetes or its complications.

Predictors of Amputation and Recurrence among Hospitalized Patients with Diabetic Foot Ulcers

Pezhman Kharazm

Background and Objective: Diabetic foot ulcers (DFUs) are a major complication of diabetes and frequently lead to hospitalization, amputation, and recurrence. This study aimed to identify predictors of amputation and recurrence among hospitalized patients with DFUs.
Methods: This descriptive-analytical study reviewed the medical records of 224 patients (123 men and 101 women; mean age, 59.3±3.11 years) hospitalized with DFUs. Extracted variables included age, sex, ethnicity, occupation, duration of diabetes, interval from diabetes diagnosis to ulcer development, smoking status, ulcer severity at admission (Wagner grade), treatments received (antibiotics, debridement, and amputation), recurrence frequency, and laboratory values at admission (Hb, WBC, ESR, CRP, and HbA1c). Primary outcomes were in-hospital amputation at any level and repeated recurrence of the original ulcer at the same site on two or more occasions.
Results: Wagner grades 2-5 predominated, with grade 2 being the most common. The rates of amputation and repeated recurrence were 31.3% and 40.2%, respectively. Higher hemoglobin levels were associated with lower odds of amputation (95% CI:0.52-0.86, OR=0.67, P<0.002), whereas higher WBC counts were associated with higher odds of this outcome (95% CI: 1.02-1.23, OR=1.12, P<0.018). Compared with Wagner grades 1 and 2, Wagner grade 4 (95% CI: 2.18-11.94, OR=5.10, P<0.001) and grade 5 (95% CI: 3.89-39.51, OR=12.40, P<0.001) were significantly associated with increased odds of amputation. Each 1-g/dL increase in hemoglobin was associated with significantly lower odds of recurrence (95% CI: 0.58-0.94, OR=0.74, P<0.012), whereas each 1×10^3/µL increase in WBC count was associated with significantly higher odds of recurrence (95% CI: 1.01-1.18, OR=1.09, P<0.026). Compared with Wagner grades 1-2, grade 4 (95% CI: 1.42-7.44, OR=3.25, P<0.005) and grade 5 (95% CI: 1.78-12.91, OR=4.80, P<0.002) were significantly associated with increased odds of recurrence. Smoking was also associated with increased odds of recurrence (95% CI: 1.05-3.63, OR=1.95, P<0.034).
Conclusion: Hemoglobin level, WBC count, Wagner grade, and smoking are key predictors of amputation and recurrence among patients with DFUs.

Role of Color Doppler Ultrasonography in Predicting Successful Embryo Transfer Based on Endometrial Receptivity in Infertile Women

Foroogh Mohammadi

Background and Objective: Infertility is a major global health challenge, and inadequate endometrial receptivity is recognized as an important cause of implantation failure in assisted reproductive treatment. Noninvasive assessment of endometrial readiness is important for optimizing the timing of embryo transfer in IVF cycles. This study aimed to evaluate the role of color Doppler ultrasonography in predicting successful embryo transfer based on endometrial receptivity in infertile women.
Methods: This prospective cohort study included 85 women with unexplained infertility undergoing IVF-ET at Shahid Sayyad Shirazi Teaching Hospital in Gorgan, Iran. Transvaginal Doppler ultrasonography was performed before embryo transfer to measure endometrial thickness and morphology, myometrial echogenicity, uterine artery flow indices, and endometrial and myometrial vascularity. The uterine scoring system for reproduction (USSR) parameters evaluated included endometrial thickness, endometrial morphology, endometrial and myometrial blood flow, uterine artery Doppler index, and myometrial contractions. Endometrial vascularity was divided into four zones according to the Applebaum classification, with zone 3 indicating vascular penetration into the inner hypoechoic layer of the endometrium. Pregnancy outcomes were compared between women with successful and unsuccessful implantation.
Results: Pregnancy occurred in 32.9% of the women. Endometrial thickness and the extent of zone 3 vascularity were significantly associated with successful pregnancy. The highest implantation rate (51%) was observed among women with an endometrial thickness of 7-9 mm (P<0.05). Women with no blood flow in zone 3 had a significantly higher pregnancy rate than those with low flow (P<0.05). Other variables, including endometrial morphology, uterine artery pulsatility index, myometrial contractions, and the USSR scoring system, showed no significant predictive value.
Conclusion: Certain Doppler ultrasonographic indices, particularly optimal endometrial thickness and vascular patterns, may help identify cycles with greater potential for successful implantation.

Frequency of Facial Skeletal Patterns among Individuals with Impacted Mandibular Third Molars

Hakimeh Ghorbani

Background and Objective: Impacted mandibular third molars (M3Ms) should be treated promptly after diagnosis. This study aimed to determine the frequency of facial skeletal patterns among individuals with impacted M3Ms.
Methods: This retrospective descriptive-analytical study examined 312 lateral cephalometric radiographs and 312 panoramic radiographs from patients (130 men and 182 women; mean age, 23.51±2.73 years) with bilateral impacted M3Ms who attended the Department of Orthodontics at Babol Dental School during 2009-2021 (a 12-year period). Sagittal skeletal patterns were assessed using the ANB angle and Wits appraisal. Facial type was classified as mesofacial, brachyfacial, or dolichofacial using the facial axis angle. Mandibular length was measured and classified as short, normal, or long. The degree of M3M impaction was assessed radiographically using Winter's classification and the Pell and Gregory system.
Results: The dolichofacial growth pattern was the most common (39.7%), followed by brachyfacial (34.0%) and mesofacial (26.3%) patterns (P<0.05). Skeletal Class I was the most common (44.6%), followed by Class II (40.4%) and Class III (15.1%) (P<0.05). A long mandible was observed in 45.8% of participants, a short mandible in 30.8%, and a normal mandibular length in 23.4% (P<0.05). The most common M3M angulation was mesioangular (50.0%), followed by vertical (33.0%), horizontal (10.3%), and distoangular (6.7%) impactions (P<0.05). According to the Pell and Gregory classification, Class A and B impactions (45.8% each) were considerably more common than Class C impactions (8.3%). Regarding the ramus relationship, P1 (47.4%) and P2 (44.9%) were more common than P3 (7.7%) (P<0.05).
Conclusion: The dolichofacial pattern, a long mandible, and skeletal Class II were the most common characteristics among patients with impacted third molars. Mesioangular, Class A/B, and P1 were the most common impaction types. These findings highlight a possible association between facial skeletal morphology and third-molar impaction.

Concordance of Empirical Antibiotic Therapy with Definitive Prescriptions and Antibiogram Results

Samira Eshghinia

Background and Objective: Early antibiotic administration is a cornerstone of infection control and treatment. Empirical treatment based on clinical signs and available guidelines reduces mortality and accelerates recovery; however, a lack of information about bacterial species and antibiotic susceptibility may lead to unfavorable outcomes. This study aimed to assess the concordance of empirical antibiotic therapy with definitive prescriptions and antibiogram results.
Methods: This descriptive study included 152 hospitalized patients receiving antibiotics (80 men and 72 women; mean age, 54.41±20.91 years), enrolled by census sampling from the infectious diseases and surgical wards of Shahid Sayyad Shirazi Teaching Hospital in Gorgan, Iran during 2021. Demographic characteristics and data on the initial diagnosis, empirical antibiotic type, microbial culture and antibiogram results, definitive treatment, and treatment duration were extracted from patient records and evaluated.
Results: The most common clinical manifestations were fever (77%) and weakness and fatigue (39%), while the leading reasons for hospitalization were sepsis (31.58%) and urinary tract infection (25.66%). Blood (45.39%) and urine (32.24%) were the most frequently cultured clinical specimens. Escherichia coli (38.8%) and Staphylococcus epidermidis (23.7%) were the most commonly isolated bacteria. Empirical antibiotics were prescribed on 454 occasions, but antibiograms were performed in only one-quarter of cases. The commonly used antibiotics for which antibiograms were performed included ciprofloxacin (14.5%), clindamycin (42%), and ceftriaxone (66.2%). Amikacin (68.4%), ceftriaxone (64.5%), and gentamicin (56.6%) were the antibiotics most frequently included in antibiogram testing. Empirical and definitive therapy were concordant in 75% of cases. The most frequently prescribed antibiotics in definitive therapy were ciprofloxacin (14.04%), clindamycin (13.2%), and ceftriaxone (12.9%). The highest concordance rates in definitive therapy were observed for doxycycline (90%), Tavanex (89.4%), and ciprofloxacin (87.3%), whereas gentamicin (83.3%) and ceftriaxone (40.2%) showed the highest discordance rates.
Conclusion: Empirical antibiotic prescriptions were concordant with definitive prescriptions in most patients. Nevertheless, the antibiotics included in antibiogram testing were not fully aligned with those prescribed in clinical practice.

Preoperative and Intraoperative Characteristics of Scleral Buckling Surgery at Khatam Al-Anbia Hospital in Mashhad

Javad Sadeghi

Background and Objective: Rhegmatogenous retinal detachment is an ophthalmic emergency that can lead to irreversible visual complications without prompt surgical intervention. This study aimed to characterize the preoperative and intraoperative features of scleral buckling surgery.
Methods: This retrospective descriptive study reviewed the records of 606 patients (374 men and 232 women; mean age, 37.18±18.8 years) who presented with retinal detachment and underwent scleral buckling surgery at Khatam Al-Anbia Hospital in Mashhad, Iran during 2016-2021 (a five-year period). Preoperative information included visual acuity, lens status, location and extent of the retinal tear, and macular involvement. Intraoperative information included procedure duration, cryotherapy, subretinal fluid drainage, the type of device used (sponge, band, or band plus tire), and the type and number of surgical sutures.
Results: At the initial visit, 51.7% of patients had a preoperative visual acuity below 0.3, and the macula was involved in 36.8% of cases. The inferior retina was the most common site of detachment (35.9%), and 180 degrees was the most common extent of detachment (46.3%). In most cases, scleral buckling was performed using a combination of buckling elements, such as a band plus tire (46%). Cryotherapy was performed in 48% of cases.
Conclusion: Most patients were young or middle-aged men who presented with poor initial visual acuity and inferior retinal detachment; in more than one-third of cases, the macula was already detached at presentation.