مجله دانشگاه علوم پزشکی مازندران
پیاپی 171 (فروردین 1398)

 Hepatocellular carcinoma (HCC) is a most common liver malignancy and TLR9 (Toll-like receptor) is essential for CpG DNA-induced immune responses. The aim of this study was to assess the anti-metastatic effects of combined administration of silibinin and CpG-ODN2006 on human hepatocellular carcinoma HepG-2 cell line model.    Inhibitory effects of various different concentrations of silibinin and CpG-ODN2006 on HepG-2 cells growth and detection of best dosages for simultaneously treatment were assessed by MTT method. Expression of MMP2 and TLR9 genes was analyzed by real- time PCR. Gelatin zymography was used to determine the activity of MMP2.  Inhibitory effects of determined concentrations of silibinin (100 μM) and CpG-ODN2006 (100 nM) on HepG-2 cells growth was significant (p<0.05). Real-Time PCR showed no significant differences between Ct of the genes expression analyses.   Collectively, the data in this study supports the idea of combined silibinin-CpG administration in hepatic cancer customized therapeutic modalities. However, more investigations to assess immunomodulatory effects and safety analyses would be very informative steps in advance of randomized clinical trials.

Toxoplasma gondii (T. gondii) as a causative agent of toxoplasmosis, is an obligate intracellular parasite which is excreted by the cat's feces. Efforts have been made for the development of toxoplasmosis vaccine, but none led to developing a vaccine with protective immune response to the parasite. Adjuvants are essential for vaccine formulation to create strong immune responses. As an adjuvant, nanomaterials such as nano-alum, can stimulate both humoral and cellular immune responses. The present report aimed to investigate the protective effects of the alum-based nano-adjuvant formulated in killed T. gondii. In this experimental study, the vaccine candidates were separately formulated in alum, complete Freund, and nano-alum adjuvants. The BALB/c mice were immunized three times with two-week intervals. To investigate the type of induced immune response, sera were analyzed by ELISA for total IgG, IgG1, and IgG2a isotypes and also IL-4, IFN-γ, TNF-α, and IL-2 cytokines. To evaluate lymphocyte proliferation, BrdU method was performed. Immunization of mice with killed Toxoplasma vaccine formulated with nano-alum adjuvant increased lymphocyte proliferation, TNF-α, IL-4, IL-2, and IFN-γ cytokine responses, total antibodies, as well as IgG1 and IgG2a subtypes compared with those of other experimental groups. Compared with alum-based killed Toxoplasma vaccine, the nano-alum adjuvant could strongly induce cellular and humoral immune responses.

Amniocentesis is the most commonly used method for diagnosis of aneuploid and other genetic disorders of the fetus. Cautious should be taken when entering the amniocentesis needle to avoid entering the placenta. The purpose of this study was to investigate the consequences of needle transposition from the placenta during amniocentesis. In a cohort study, 1000 pregnant women candidates for amniocentesis were selected from Mashhad Perinatology Clinic, 2014-2016. A needle was inserted into the gestational sac and 20cc amniotic fluid was taken, using the ultrasound guidance. Passage or not passage of needle through the placenta was recorded and complications such as abortion, spotting, preterm labor, and rupture of membrane in each group were compared. Data analysis was done in SPSS applying Kolmogorov-Smirnov test, t-test, and Chi-square. The relative risk (RR) was also calculated. The mean age of participants was 33.4 years old (16-48 years of age). Spotting after amniocentesis was recorded in 1.4% nontransplacental amniocentesis and in 6.1% of transplacental amniocentesis (RR; 6.85, p=0.03). There was no significant relationship between needle passage through the placenta and other complications such as abortion, amnionitis, preterm labor, and amniotic fluid leakage following amniocentesis (p=0.08). Current findings showed that transplacental amniocentesis increases the probability of spotting following amniocentesis.

Lack of healthy air in classrooms and homes will reduce the level of health and disrupts students’ learning. The aim of this study was to determine the relationship between CO2 concentration and other environmental parameters with sick building syndrome in schools and homes in Babol, north of Iran, 2018. To measure carbon dioxide, temperature, and humidity, the TES 1370 was used. This study was conducted among 85 students in five primary, secondary, and high schools. Selection of schools, classrooms, and students was performed using a multistage random sampling. Data were collected through interviews using MM040EA questionnaire. Chi-square, ANOVA, and T-test were used to determine the relationship between sick building syndrome and environmental parameters. The most common symptoms of building syndrome were fatigue (45.8%) in winter and headache (35.3%) in spring. T-test showed significant relationships between carbon dioxide and building syndrome signs in winter (P= 0.02) and spring (P= 0.01) in classrooms and homes. But there was no significant relationship between the syndrome and moisture and temperature. Among the risk factors investigated in winter and spring, noise was reported as an annoying risk factor. The study showed that concentration of carbon dioxide has a significant relationship with development of sick building syndrome in students. The symptoms of sick building syndrome were found to be mild in our samples, but due to poor physical conditions in some schools and even in home settings, optimization of these spaces should be done.

Breastfeeding self-efficacy is the feeling of confidence of the mother to experience exclusive breastfeeding. The aim of this study was to compare the effect of talks and motivational interviews on breastfeeding self-efficacy in primiparous women. This randomized controlled clinical trial was conducted in 210 primeval pregnant women attending Torbat Heydarieh health centers, Iran 2017-2018. Random block method was used and the subjects were assigned into three groups (n=70 per group), including those participating in motivational interviews, attending the talk session, and controls. Motivational interview was carried out in five sessions (two hr) and three telephone follow ups were made. The talk group were given a two- hour talk about breastfeeding and received relevant trainings, while the control group only received routine care. The groups were evaluated for breastfeeding self-efficacy at two, four, and six months after childbirth. Data were analyzed applying Chi-square and ANOVA. Demographic variables were not significantly different between the groups (p>0.05). Six months after childbirth, the mean scores for breastfeeding self-efficacy were 63.97±0.89, 50.02±0.91, and 41.77±0.95 in the group participating in motivational interviews, the talk group, and controls, respectively. The score revealed significant differences between the three groups in breastfeeding self-efficacy (p<0.001). Motivational interview was found to be more effective in enhancing breastfeeding self-efficacy, therefore, it is suggested as an effective and inexpensive method, especially in primiparus women.   (Clinical Trials Registry Number: IRCT IRCT2014122220394N1)

High prevalence of hypertension (HTN) and its detrimental effects have resulted in more use of traditional and complementary medicine. This study aimed to investigate the knowledge and attitudes of hypertensive patients on the use of traditional and complementary medicine. This descriptive study was performed in 400 hypertensive patients attending an academic outpatient clinic in Mazandaran Heart Center, Iran 2017. Data were recorded by a demographic questionnare and a researcher-made questionnaire about the knowledge and attitudes of hypertensive patients on the use of traditional and complementary medicine. Data were analyzed using Chi-square, independent t-test, and Pearson’s correlation coefficient. The mean HTN was 14.19±3.14 mm/Hg. Low and moderate awarness about the use of traditional and complementary medicine were seen in 63.5% and 36.5%, of hypertensive patients, respectively. Among the patients, 14% were found to have moderate attitude and 86% had positive attitude towards traditional and complementary medicine. Significant associations were found between attitude and marital stuatus, educational level, occupation, place of residence, comorbidities, and family history of the disease (P <0.001). There was a direct correlation between attitude and age (P= 0.01, r= 0.14) but a significant negative correlation between attitude and duration of HTN (P= 0.03, r = -0. 12). More than half of the patients had low knowledge about the use of traditional and complementary medicine, however, they were found to have positive attitudes toawrds traditional and complementary medicine. Therefore, health authorities are recommended to provide people with more information on traditional and complementary medicine.

Hysterectomy is the second most common cause of surgery in women of reproductive ages. Evidence show that women who undergo hysterectomy suffer from psychological and physical illnesses. The present study aimed to investigate the effect of counseling with cognitive-behavioral approach on self-esteem of hysterectomized women of reproductive ages. This clinical trial was performed in 40 women aged between 15-45 years who were hysterectomized in Ahvaz Imam and Razi hospitals, 2018. Women with scores ≤15 Rosenberg self-esteem scale were divided into two groups of test (n=20) and control (n=20). The test group attended 12 sessions of cognitive-behavioral therapy and the control group received no training. Data were collected using Rosenberg self-esteem scale, Beck Depression Inventory, and a demographic questionnaire. Data analysis was done applying independent t-test, Chi-square, and repeated measures ANOVA. The mean score for self-esteem was not significantly different between the two groups before the intervention (P= 0.527). But, the mean score for self-esteem before and after the intervention in the test group increased from 12.22±1.83 to 22.72±±1.52 (P< 0.001) and in the control group decreased from 11.89±±1.19 to 11.47±±1.38 (P= 0.001). Also, a significant difference was found between the two groups during the post-intervention period (P< 0.001). Cognitive-behavioral therapy could be used as an effective therapeutic approach to improve the self-esteem of hysterectomized women in reproductive ages.

Communication technologies have a dual effect on human health and life. In fact beside their major role in improving human well-being, they also have harmful consequences. This research aimed at studying media technologies and their relationship with health related quality of life in students. In this cross-sectional study, a total of 567 high school students in Kermanshah, Iran 2017. They were selected using multi-stage sampling and completed a demographic checklist, media usage checklist, and WHOQOL-BREF questionnaire. Data were analyzed in SPSS V18, using Pearson correlation coefficient, linear regression, one-way and two-way ANOVA. The mean score for total quality of life was 62.33 ± 15.76. Daily uses of computer, laptop, mobile phone, tablet, TV, and satellite program were 61.1%, 87.2%, 26.4%, 86.9%, and 26.9%, respectively. The mean score for overall quality of life in using mobile phone, tablet, and satellite program was significantly different between the adolescents (P< 0.01), but there was no significant difference between them in using TV and computer (P> 0.05). In general, no use or low use of satellite programs were associated with better scores for quality of life. But using mobile phone, tablet, computer, and laptop for two hours a day was associated with higher quality of life scores, compared with their use for more than two hours per day. Therefore, limited use of media technologies could lead to better health related quality of life.

Cisplatin (CP) is an anticancer drug that cause hematological changes. Zataria Multiflora Boiss (ZM) has antioxidant property. The preset study was done to determine the protective effect of ZM against hematological changes induced by Cisplatin in mice. Thirty two adult male mice (25-30 g) were divided into 4 groups: the control group received normal saline for 7 days; ZM group received ZM (200 mg/kg) for 7 days by gavage; CP group received Intraperitoneal CP (10 mg/kg) injection at day 5; ZM + CP group received ZM for 7 days and CP was injected at day 5. Then, blood samples were taken for hematological assessment at day 8 of the study. Data were analyzed by SPSS applying ANOVA and Tukey test. The number of red blood cells, hemoglobin levels, platelets, MCV, MCH, and MCHC significantly decreased and white blood cells increased in the group that received CP compared with those of the control group. ZM improved these changes (P<0.05). ZM improved hematological changes induced by Cisplatin in mice.

Menopause is a normal physiological process which influences the life of many middle-aged women. Studies reported different results on the effects of various factors on severity of menopausal symptoms. This study was designed to identify the factors determining menopausal symptoms in postmenopausal women in Tehran, Iran 2015. This cross-sectional study was conducted in 307 postmenopausal women aged 45–65 years old selected by convenience sampling. Data were collected using a demographic questionnaire and the Menopause Rating Scale (MRS). Blood sample were taken to measure estradiol levels. Data were analyzed applying Spearman correlation coefficients, Mann-Whitney test, and Stepwise multiple linear regression. In this study, significant negative associations were found between menopausal symptoms and at marriage (r= -0.12, P=0.03), age at first pregnancy (r= -0.11, P=0.04), education level (r= -0.24, P<0.001), and estradiol level (r= -0.32, P<0.001). We observed significant positive associations between menopausal symptoms and parity (r=0.19, P=0.001) and BMI (r=0.11, P=0.04). A significant difference was observed between the groups with and without physical activity (P=0.01). Regression analysis showed estradiol levels (P<0.001), education level (P=0.001), and physical activity (P=0.015) as strong predictors of menopausal symptoms. In order to improve the severity of menopausal symptoms, alongside hormone therapy, women should be advised to adopt a healthy lifestyle and do more physical activities.

Preoperative airway assessment is of great importance. The aim of this study was to investigate the attitudes of anesthesia and emergency medicine personnel towards preoperative airway assessment and its use in hospitals located in north of Iran. This descriptive cross-sectional study was conducted among anesthesiology personnel in the hospitals of Mazandaran and Golestan provinces and Babol hospitals. Data was collected using a researcher-made questionnaire consisting of personnel demographic information, airway assessment techniques, and attitudes (8-item Likert scale). Data analysis was done applying t-test, ANOVA, Chi-square, and Fisher test. The research population included 215 people of whom 193 (49.7% in Mazandaran province, 23.3% in Babol, and 26.9% in Golestan province) completed the questionnaires. The respondents included 64.2% females. Totally, 83.9% were found to have positive attitudes towards preoperative airway assessment. The mean score for attitude was 32.6±3.2 (23-40). There were significant differences between the attitudes of anesthesiology technicians, residents, and anaesthetists (OR= 2.648, CI: 95% [1.348-5.202], P <0.003). Among the participants, 94.3% reported using short neck assessment in preoperative airway assessment. Among numerous airway assessment techniques, the participants had a positive attitude towards using some of them. Therefore, more evidence-based tests are needed in training programs.

Breast cancer is one of the most common cancers in women. As we know, cardiac metastases occur rarely. In this study, a 40-year-old woman referred to the hospital due to severe pain in the right leg. She was diagnosed with deep vein thrombosis (DVT) and received treatment, but, after one month and a half she returned with severe pain, exacerbated shortness of breath, cramping pain, and chest pain. With the diagnosis of lung embolism, she received anticoagulant therapy and discharged after recovery. Then, about two months later, the patient was admitted for the third time, with symptoms of shortness of breath, chest pain, and right foot edema. In Doppler echocardiography, acute to chronic thrombosis was reported in femoral popliteal vein and common femoral vein with external liliac expansion. Based on the computed tomography angiography (CTA) and Echocardiography, the patient was diagnosed with pulmonary embolism with a mass in the right ventricular, so, cardiothoracic surgery consultation was done. During the operation, extensive spread of metastasis was seen on mediastinum, the aorta, and pericardial space. A biopsy was performed and metastatic breast cancer was reported. This study signifies the importance of examining patients with recurrent DVT for malignancy.

Avulsion is complete displacement of tooth from its alveolar socket. Immediate replantation is the best choice at the site of accident. When replantation is not possible, it should be kept in a storage medium. The storage media keeps periodontal cells with less damage to be able to regenerate and attach and prevents root resorption. The medium selected as a storage medium should be easily available and have adequate osmolality, appropriate PH, nutritional metabolites, and fair price and should not have bacterial content. In literature, different storage medium are suggested, including those containing Hanks balanced salt solution (HBSS), natural products such as water, Aloe Vera, propolis, pomegranate juice, coconut juice, green tea, egg white, milk (whole, low-fat and skimmed milk, butter milk, soy milk, probiotic milk, pasteurized milk, and mixture of egg white and milk), rehydration solutions such as ringer lactate serum, cell culture medium such as eagle culture medium or EMT (emergency medical treatment) tooth saver, medical media used for keeping organs such as viaspan, commercial media such as GC Tooth Mousse, growth factor treatment, and laser irradiation before tooth replantation. Due to studies limitations and heterogeneous data, nothing is recognized as an ideal medium.

Autism spectrum disorder (ASD) is a psychiatric disorder which occurs in early years of life and causes various individual and social problems. Early detection of autism would help in taking necessary precautions and preventing its adverse side effects. In this paper, we reviewed the articles that have investigated brain structural changes caused by ASD based on brain volumetric analysis in magnetic resonance images. We studied 37 papers about brain volume measurement, 34 articles concerning brain structural changes in autistic patients, 9 about brain functional changes, and 15 on major causes, diagnosis, and treatment of autism. According to literature, autism leads to whole brain enlargement (1.58%-10%). ASD was reported to cause increase in the volume of left anterior temporal gyrus, left posterior cingulate gyrus, right calcarine sulcus, left and right lingual gyrus, left precuneus, and right thalamus. But, no considerable volume changes were detected in the white matter. Also, autistic patients were found to have lower activity in the fusiform gyrus and broca region compared to normal subjects. Brain structural analysis using magnetic resonance imaging provides promising evidences for early detection of autism in children younger than three years of age. However, to evaluate brain structural changes in autistic patients, considering the theory of age-specific anatomic abnormalities (brain enlargement in childhood and brain volume decrease in adulthood), gender, and intelligence quotient are necessary.

Kidney and urinary tract stones are the most painful diseases of the urinary system that affect the quality of life. At present, various treatments such as medications, crushing and surgical treatments are used which are not effective in some cases or have some complications. Therefore, more efficient and less costly treatments are preferred. In Persian Medicine, the disease is widely investigated. In this study, effective medications on the break down of kidney and urinary tract stones are reviewed in Persian literature and sources at different time periods. Also, plants which are more recommended or used in clinical studies are presented.

Correction to: Relationship between Air Pollution and Mortality Rate due to Chronic Obstructive Pulmonary Diseases in Mashhad, Iran     Narges Ghorbani1, Jamshid Yazdani-Charati2,  Siavash Etemadinejad3, Nasrin Ghorbani4   1 PhD Student in Biostatistics, Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran 2 Associate Professor, Department of Biostatistics, Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran 3 Associate Professor, Department of Occupational Health and Ergonomics, Health Sciences Research Center , Mazandaran University of Medical Sciences, Sari, Iran 4 Medical Records Technician, Omid Hospital, Mashhad, Iran          In the article published in volume 28, issue 169, 2018, the affiliation for the corresponding author was published incorrectly, which is now corrected.