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Introduction: Migraine is one of the widespread discases in the word, being 15-20 percent prevalent in women, and 6 percent in men. The attacks resulting from the migraine usually range from minor to major, and even may make the patient unable to work. Its dangerous and permanenet effects may also led to paralysis of different parts of the body. Therefore, it is necessary to do more investigations concerning diagnosis and drug treatments which can prevent the migraine attacks better.
Materials and Methods: The study was a randomized controlled trial which lasted for six months. The patients have been studied through different ways including case history, checkup. electroencephalogram (EEG), computed tomography scanning, blood sampling, kidney and liver function and starting time of the treatment. Successful treatment responses to control migrainc attacks using the prophylactic drugs. Valproate Sodium and Propranolol with tricyclic antidepression drugs, i.e., Amitriptyline and/or Nortriptyline were studied.
Results: Of 126 patients studied (31.8% were men and 68.2% women), 65.1% had normal EEG and 34.9% had abnormal EEG. The patients using Valproate Sodium with normal and abnormal EEG had successful treatment responses equal to 35% and 95.6%, respectively. Additionally, other patients using Propranolol with tricyclic antidepressant Amitriptyline and/or Nortriptyline with normal and abnormal EEGs had successful treatment responses equal to 61.9% and 28.6%, respectively. Statistically, the results were significantly different. However, there were not significant differences between interactive effects of the drugs in sexes, and sexes in EEG types. The most prevalent side effects due to Valproate Sodium and Propranolol with tricyclic antidepressant drugs, i.e., Amitriptyline and/or Nortiptyline were vertigo and exhaustation, respectively.
Conclusion: This study revealed that the best treatment to prevent migraine attacks was using Valproate Sodium tablets in patients with abnormal EEGs, and using Propranolol tablets along with Amitriptyline and/or Nortriptyline for those who had normal EEG.

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Introduction: Serum Alkaline Phosphatase (ALP) is a glycoprotein that is secreted from osteoblasts. In fractures, the rate of ALP will be changed. Low intensity pulsed ultrasound accelerates the growth and remodeling of fractures. However the relation between pulsed ultrasound and changing the rate of serum ALP in New Zeland rabbit is not studied yet. The aim of this study is to investigate the effect of pulsed ultrasound on serum ALP during bone healing of tibia in New Zealand rabbit. Materials and Methods: This is an experimental study. 54 male and mature New Zealand rabbits were randomly divided into six groups (3 experimentals and 3 controls). All of them were operated for inducing a model of experimental fracture. After repair of wounds, the right leg of experimental groups was exposed to pulsed ultrasound for 2, 4 and 6 weeks. The control groups were kept without any intervention during the same time. After experiment, the rabbits were anesthesied and blood samples were taken from their hearts for ALP serology, and then the rabbits were killed. Blood was centrifuged and serum ALP was read by spectrophotometer. Data was analyzed by Mann-Whitney U and Kruskal-Wallis tests. Results: Results showed that the mean serum ALP level in experimental group after 4 weeks exposing to pulsed ultrasound was significantly higher as compared to control group (p= 0.03). There was no significant difference between the other groups. Conclusion: The results of this study demonstrate that pulsed ultrasound wave increases serum ALP and accelerates the bone healing.

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Abstract Background: Aloe Vera species have diverse immunomodulatory and antitumor activities. The present study was set out to define the immunomodulatory activity of Aloe Vera extract on tumor necrosis factor-alpha (TNF-α) and development of experimental autoimmune encephalomyelitis (EAE) as an animal model of multiple sclerosis (MS). Materials and Methods: In this experimental interventional study, EAE was induced by MOG35-55 peptide and complete Freund's adjuvant in C57BL/6 mice. Mice were placed in two therapeutic groups (n=8 per group) with the same age and weight. Therapy with Aloe Vera extract (120mg/kg/every day given oral) was started on day 5 before the immunization until 25 day after that. EAE control received phosphate buffer alone with same schedule. Signs of disease were recorded daily until the day 25 when mice were bled and sacrificed. Produced TNF-α by cultured spleen mononuclear cells was detected by ELISA. Results: The Aloe Vera treatment significantly reduced the clinical signs of EAE and delayed onset of disease. Mononuclear cells isolated from spleen of treated-mice with Aloe Vera showed a significant decrease in TNF-α in compared with control mice (p=0.012). Conclusion: Aloe Vera ameliorated the EAE and reduced TNF-α level in MS animal model.

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Background: The purpose of the present study was to investigate the probable changes of HSP70 , liver enzymes & Cpk in professional athletes after a training season and participating in skating open world championship.

Materials and Methods: 10 elite female skaters were chosen. Eccentric exercise test were performed in three sections (24 hours before the beginning of the training, after six months of training (before participating in Skating World Championship) and 24 hours after the end of world championship). The training program consisted of 26 weeks of training, performed 5 times a week encompassing specialized skate trainings. Blood samples were taken before and after each eccentric exercise test.

Results: there was no significant change, in HSP70 concentration in response to eccentric exercise test, in pre exercise period (p>0.898). But, it illustrated a significant increase in after eccentric exercise test, in post exercise period (p<0.031). Moreover, in measuring down, it showed a significant increased in the amount of liver enzymes and Cpk after eccentric exercise test in second and third step compared to first step (p<0.05).

Conclusion: the results of the study illustrated that improving an athlete's physical fitness level during training season and matches leads to a significant increase in the protective level of the body (via the production of HSP70), depending also on the ability of the body of the individual in producing that protein. It can also be stated probably individual body fitness level, is an important factor in determining ALT, AST, ALP levels after performing eccentric exercise.

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Background: Rheumatoid arthritis is an inflammatory disease. Hypertension could occur as a result of chronic inflammation in RA patients. Some evidence demonstrates anti-inflammatory effects of alpha-lipoic acid in inflammatory diseases. However, a limited number of studies have evaluated the effects of alpha-lipoic acid in rheumatoid arthritis. Therefore, the current study was designed to investigate the effects of alpha-lipoic acid supplementation on blood pressure and some inflammatory factors.

Materials and Methods: The present study was a randomized, double-blinded, placebo-controlled clinical trial in which 70 female patients aged 20–50 years were randomized to two groups to receive either alpha-lipoic acid (1200 mg/day) or placebo. The intervention duration was 8 weeks. Systolic and diastolic blood pressures were measured before and after the supplementation period. Also, C-reactive protein (CRP) and interleukin-6 (IL-6) were measured. Statistical analysis was done using SPSS13 software.

Results: 65 RA patients completed the trial. Systolic and diastolic blood pressure in alpha-lipoic acid group was significantly decreased in comparison with placebo group (p<0.05). But, CRP and IL-6 serum levels did not indicate any significant within- and between group changes.

Conclusion: In the present study, alpha-lipoic acid supplementation resulted in significant blood pressure reduction in rheumatoid arthritis participants.

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Background: Estrogen hormone regulates cell proliferation in breast tissue physiologically. Evidences show that changes in estrogen signaling pathways, including the receptor alpha (ER&alpha), happen during breast cancer progression. ER&alpha is expressed in most breast tumors and its association with the development of low-grade tumors has been demonstrated. Single nucleotide polymorphisms (SNPs) in genes may differ in susceptibility to cancer and result in different respond to treatment in different populations. The present study aimed investigated the association between single nucleotide polymorphisms (rs2234693: C/T) in gene ESR&alpha in patients with breast cancer.

Materials and Methods: In this case-control study 150 women with breast cancer and 142 healthy women without a family history of breast cancer were enrolled. DNA was extracted from blood samples. After primer design, technique of PCR-RFLP was used and samples were genotyped by acrylamide gel electrophoresis. Statistical analyzes were performed using SPSS version 20 and chi square test and Final findings were specified.

Results: TT and CT genotypes for ra2234693: C/T site compared with the CC had 5.5 and 1.5-fold increased risk respectively. Statistically significant differences were found between cases and controls for fibrocystic disease and age at menarche.

Conclusion: We not found an association between C/T polymorphism and breast cancer. But CC and TT genotypes of this polymorphism in estrogen receptor alpha gene related with breast cancer that are consistent with the findings of some other researchers.

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  Background: Alpha-tocopherol, as a strong antioxidant, plays an important role in testraining free radicals. The aim of this study was to investigate the effect of Alpha-tocopherol on cell proliferation and restraining apoptosis in rat bone marrow mesenchymal stem cells.

  Materials and Methods: In this research study, the rat bone marrow mesenchymal stem cells were extracted under sterile conditions using flashing-out method. At the end of the third passage, cells were divided into groups of control and Alpha-tocopherol with doses of 15 and 25 µM and were treated in the osteogenic media cell medium containing 10% fetal bovine serum, 10 mM β-glycerol phosphate, 10 nM dexamethasone and 50 µg/ml ascorbic 3-phosphate] for a period of 21 days. Then, cell proliferation, DNA damage, expression of Bcl-2 and Bax genes and the morphologic changes of the cells were investigated during the procedure of osteogenesis. Data were analyzed using one-way ANOVA and means difference was considered significant at p<0.05.

  Results: Cell proliferation, the size of nuclei diameter and expression of anti-apoptotic Bcl-2 gene showed a significant increase in mesenchymel stem cells treated with Alpha-tocopherol (p<0.05) in a dose dependent manner compared to the control cells. Also, cytoplasm extension was seen in the cells treated with Alpha-tocopherol, compared to the control group. Since Alpha-tocopherol causes a significant decrease in DNA damage and the expression of apoptotic Bax gene, compared to the control group, therefore it can suppress apoptosis in bone marrow mesenchymal stem cells, in a dose dependent manner .

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Background: Infertility is a multifactorial disorder with genetic and non-genomic factors. It is estimated that female infertility factors accounts for more than 40%. Estrogen is one of the effective hormons  in fertility. Its crucial actions on target tissues are mediated via binding to estrogen receptors(ESR). The ESR1 gene is located on chromosome 6q25.1 and encodes α estrogen receptor. The aim of this study was to analysis of ESR1 rs104893956 polymorphism in female infertility.

Materials and Methods: In this case-control study, of 60 infertiles and 55 healthy controls, blood samples were attained. After the extraction of genomic DNA from peripheral blood leukocytes, Allele Specific-PCR (AS-PCR) method was applied for determining the codon polymorphism. Statistical analysis was performed using the MedCalc software (Version 12.1).

Results: The frecuency of T allele was significantly higher in patients (58%) than the controls (44%). There was higher frequency of TT genotype of the polymorphism in patients (18.33%) compared with controls (1.8%). Our findings revealed that the patients carrying the TT genotype had a significant increased risk of infertility.

Conclusion: The results of this study suggests that ESR1 rs104893956 polymorphism may affect the increased susceptibility to female infertility in Guilan province. The results may be different in other genetic pools or large-studied population.

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Background: Inflammatory bowel disease (IBD) includes two basic categories ulcerative colitis (UC) and Crohn's disease (CD) that the etiology of which remains unclear. Tumor necrosis factor alpha (TNFα) promoter polymorphisms are a good candidate for susceptibility to IBD as there is a significant relationship between them. The main aim of this study was to assess TNFα gene polymorphisms with IBD susceptibility at positions -1031in Iranian patients.

Materials and Methods: In this case-control study, were studied 101 patients with IBD (86 ulcerative colitis, 15 Crohn's disease) and 100 healthy controls were studied. PCR-RFLP (Polymerase Chain Reaction-Restriction Fragment Length Polymorphism) was used for determining of genotyping. In following, allele frequency and genotype distribution of polymorphism T> C in TNFα gene between the case and control groups were typed.

Results: The frequency of genotype TT, TC and CC among patients was 64.4%, 28.7% and 6.9% and in control group was 63%, 29% and 8%, respectively. Also, allele frequency T-1031 of TNFα gene in IBD patients was high, while there is no statistical significant(p>0.05).

Conclusion: There was no significant correlation between TNFα gene polymorphisms and susceptibility to IBD at position -1031. Our results showed that TNFα gene polymorphisms cannot be considered as a potential prognostic marker cause of IBD in Iranian population.

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Background and Aim: The purpose of this research is to provide nanofibers from cellulose with Wheat bran as an agricultural residue and its antimicrobial activity by dipping ciprofloxacin hydrochloride on Staphylococcus aureus. Materials and Methods: In this experimental study, cellulose disks were prepared from nano-impregnated fiber. Subsequently, these disks were placed on Staphylococcus aureus with standard paper disks and the results were measured as a non-growth zone after 24 hours. The amount of ciprofloxacin hydrochloride adsorbed in cellulose by comparing the effect of cellulosic discs containing different concentrations of antibiotics and standard ciprofloxacin disks was determined. Subsequently, the evaluation of the time of recovery of the ulcer in the skin of the rats was carried out with the drug-mediated formulation and without drug. Findings: The disk (nano alpha-cellulosic) dipped by ciprofloxacin hydrochloride created a non-growth zone in Staphylococcus aureus. Measuring the size of the wound was done by digital imaging and the ImageJ software. The results of the recovery process were analyzed by ANOVA and pathological tests in five days. Conclusion: The results showed that the nano-fibers disk could be useful in controlling bacteria in the culture medium, and the area of the wounds in rats (rats) dressed with nano-fibers impregnated with the drug was significantly less than the control group (p <0.05).

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On average, patients suffering from non-alcoholic steatohepatitis after about seven years, their disease turns into fibrosis and reversibility at this stage becomes very difficult because this disease is an irreversible stage of the disease. Fatty liver is non-alcoholic (2). Researches have come to the conclusion that liver inflammation and insulin resistance decrease and insulin sensitivity increases with sports activity (3). TNF-α has a high inflammatory effect; So that different agents and species of this family and their receptors play a role in NASH disease and liver fibrosis (5). However, exercise increases prostaglandins and cAMP. The mentioned hormones inhibit the function of TNF-α (6). On the other hand, anti-inflammatory cytokines increase due to exercise and inhibit the increase of TNF-α. With the increase in production and secretion of TNF-α, other inflammatory factors such as TGF-β1 signaling are activated and fibrosis signaling will start in liver cells (5). TGF-β1 (Transforming growth factor beta 1) is one of the members of the large family of transforming growth factors beta (TGF-β) and a key cytokine in obesity and insulin resistance (7). In a research, during 48 weeks of applying a high-fat diet to rats, they found that steatosis occurs in the liver of rats from the eighth week onwards, and the amount of TGF-β1 in them increased significantly. In the end, they came to the conclusion that this factor can be one of the main characteristics of determining the degree of liver fibrosis in patients with NASH (10). High-intensity interval training (HIIT) is one of the new training models whose positive effects have been identified in a variety of metabolic diseases (13). On the other hand, there are very few researches about the effect of aquatic environment and swimming on the improvement of metabolism and inflammation in NASH patients. Based on the results of a systematic review in 2018, it was shown that endurance exercise in water improved systemic inflammation and weight control (18). Despite the conflicting results in this field and the beneficial effects of exercise in water and also human's innate interest in water, the effect of high-intensity interval exercise in water in patients with non-alcoholic steatohepatitis has not been observed by the researchers of this study. Therefore, the effect of eight weeks of high-intensity interval training in water on inflammatory factors in patients with non-alcoholic steatohepatitis was investigated.
Materials and methods
In this study, eight-week-old rats were divided into two groups: healthy (n=20) and high-fat diet (HFD) (n=20). After eight weeks and proof of disease induction, the HFD group was randomly divided into two groups: control-disease (n=9) and exercise-disease (n=9); Also, the healthy group was divided into two groups: control-healthy (n=9) and exercise-healthy (n=9). The rats in the training group performed HIIT swimming training, including 20 times of 30 seconds of swimming with 30 seconds of rest between each time, for eight weeks (three days a week). One-way ANOVA and Bonferroni's post hoc test (P<0.05) were used to determine the difference between groups.
Ethical Considerations
The proposal of this study has been approved by the Ethics Committee of Shiraz University of Medical Sciences (IR.SUMS.REHAB.REC.1400.008).
Findings:
As shown in diagram 1; Based on the results of the one-way analysis of variance test, it can be said that there was a significant difference between the mean TNF-α blood serum (P=0.001). According to the results of Bonferroni's post hoc test, these differences in blood serum TNF-α variable between the control-healthy and control-disease groups (P=0.001), exercise-disease (P=0.001) and exercise-healthy (P=0.002), control-disease with exercise-disease (P=0.012) and exercise-healthy (P=0.001), exercise-healthy with exercise-disease (P=0.002) was.
According to graph 2, it can be seen that there is no significant difference in TGFβ1 variable in all four groups (p=0.068). However, by comparing the averages, it is found that the amount of TGFβ1 protein has decreased by 49.1968% in the patient-exercise group after high-intensity intermittent swimming exercise compared to the control-patient group. Meanwhile, this protein in the exercise-healthy group was reduced by 45.2741% compared to the control-patient. Figure 1 shows the protein bands related to TGFβ1 protein.
Discussion and conclusion: The results of the present research showed that high-intensity intermittent swimming exercises reduce inflammatory and fibrotic factors, and in general, it can be concluded that eight weeks of high-intensity intermittent swimming exercises improve the inflammatory and fibrotic factors associated with non-alcoholic steatohepatitis. . However, to obtain a definitive result, this type of exercise should be studied in human studies in this patient community.
Appreciation and thanks: This article is taken from the master's thesis in sports physiology (first author) of Zand Institute of Higher Education, Shiraz, with ethics code IR.SUMS.REHAB.REC.1400.008. In the end, we sincerely thank all friends and colleagues who helped us during the stages of this research.
Conflict of interest:The authors of this article have no mutual benefit from its publication.
Authors' share (participation rate): All four authors participated in the preparation of this article.
Key words: high-intensity swimming interval training, non-alcoholic steatohepatitis, tumor necrosis factor alpha, transforming growth factor beta

 

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Introduction: Some intracranial surgeries must be performed while the patient is awake. Awake craniotomy is an intracranial surgical procedure in which the patient remains in a state of controlled consciousness while the surgery is performed. The aim of this study was to present a case of intracranial surgery to remove a tumor in the right frontal cortex using awake craniotomy.
Case Report: This report describes the anesthetic management of a 22-year-old male undergoing craniotomy with a fully awake technique. This was the first case of craniotomy performed entirely awake (from the beginning to the end of the operation) at Arak University of Medical Sciences and Valiasr Hospital in Arak, After preoperative preparation and evaluation, scalp nerve blocks targeting the cranial nerves innervating the scalp and head muscles were administered at specific sites. Mild sedation was provided using oxygen supplementation, followed by surgical incision. The lesion was examined intraoperatively while the patient remained awake, and the tumor was safely excised under full wakefulness. A combination of local and regional anesthesia and light intravenous sedation was utilized. Two types of local anesthetics, lidocaine 1.5% and bupivacaine 2.5%, were used for anesthesia, as well as intravenous sedatives and anesthetics such as propofol, remifentanil, and dexmedetomidine were administered for sedation. Throughout the operation, the patient was awake and breathing spontaneously, and the function of the brain nerves during the operation could be evaluated. Finally, the patient's surgery was performed without any complications and in stable condition, and the patient was transferred to the intensive care unit in good general condition, awake and fully alert.
Conclusions: Although maintaining analgesia and hemodynamic and adequate ventilation during fully awake craniotomy poses challenges, this technique is critical for intraoperative monitoring of cranial nerve function and preventing neurological deficits. By precisely administering scalp nerve blocks and carefully titrating sedatives (propofol, remifentanil, dexmedetomidine), we successfully performed the procedure under full wakefulness. With this method, potential surgical complications are prevented, and the patient also experiences satisfactory painlessness. Applying this technique was satisfactory for our patient.