مجله دانشگاه علوم پزشکی مازندران
پیاپی 153 (مهر 1396)

Background and Today, increased rate of demand for insulin is predictable due to increasing cases of diabetics in the world. Therefore, it is necessary to develop economic approaches and increasing the production of insulin for the future and medicinal plants could be regarded as a promising prospect for insulin production.
The Allium ursinum and Silybum marianum were collected. Each herbarium was identified in School of Pharmacy affiliated with Mazandaran University of Medical Sciences and the extract was used by percolation with 70% ethanol extraction, after the solvent was evaporated by using the rotary. After the successful isolation of mesenchymal stem cells (MSCs), Wharton's jelly was derived and approved. Then, the mesenchymal stem cells were differentiated to pancreatic beta cells with two herbal extracts.
Compared with the control group, there was a significant difference between the levels of insulin in the culture medium obtained from the two plants (P= 0.0001). In addition, via specific dithizone staining, the insulin producing cells (IPCs) were proven.
The extracts of Allium ursinum and Silybum marianum were found capable in inducing differentiation of the mesenchymal stem cells derived from Wharton's jelly into IPCs. Allium ursinum was seen with the highest rate of insulin production, while Silybum marianum had the lowest rate of insulin production, therefore, Allium ursinum could be more effective in treatment of diabetes.

Background and Turmeric (Curcuma longa L.) has received much interest by researchers due to numerous biological properties. The aim of this study was to compare the anticancer and antioxidant properties of turmeric extracts on colon cancer cells Caco-2 and to survey DNA fragmentation by the extracts.
In order to investigate the cytotoxicity and antioxidant properties and DNA fragmentation, turmeric extracts were prepared by maceration, ultrasonic-assisted extraction (UAE), and soxhlet. The effect of these extracts and curcumin on colon cancer cells Caco-2 was examined by MTT and NBT assay. Then, to study the DNA fragmentation by the extracts DNA-Binding was done.
MTT assay showed that the lowest survival rates were observed for cells treated with the extracts of hexane and ethanol. The results of the NBT showed that the highest amount of percentage of free radicals reduction occurred with maceration extract, ultrasonic extract, and extraction by hexane and ethanol. According to DNA-Binding test, ultrasonic extraction was highly effective in degeneration of DNA.
Investigations show that different extracts of turmeric alone or in combination with chemical anticancer drugs could be used as a new approach in treatment of cancer. Turmeric extract using hexane and ethanol has a great potential in development of modern drugs and can be introduced as a useful source of new leading compounds or pharmacophores.

Background and Interest into targeting PI3K in cancer has increased by the recent disclosure that aberrant activity of PI3K/Akt signaling pathway is associated with disease recurrence and poor outcome in different malignancies. The aim of this study was to investigate the potentiating effect of PI3K inhibitor, GS-1101 on doxorubicin-induced cell death in acute lymphoblastic leukemia-derived, Nalm-6 cells.
In this experimental study, to evaluate whether abrogating PI3K/Akt pathway using GS-1101 could enhance cytotoxic effect of doxorubicin in acute lymphoblastic leukemia, Nalm-6 pre-B ALL cells were subjected to combination treatment and subsequent cell viability. Then cell count, metabolic activity, and transcriptional alteration of apoptosis-related target genes were investigated using Trypan blue exlussion, MTT and Rq-PCR analysis, respectively.
Our data delineated that GS-1101 augments doxorubicin-induced cytotoxic and its anti-proliferative effect, as evidenced by the decreased cell survival, cellular metabolic activity, and reduction in the number of inhibitor-treated viable cells. Moreover, real-time PCR analysis revealed that induction of cell death by the drug combination was associated with increased Bax transcriptional activity (P≤0.01) followed by the elevated molecular ratio of Bax/Bcl-2 (P≤0.001).
This study suggested that abrogation of the PI3K pathway using GS-1101 could potentiate doxorubicin-induced anti-leukemic activity.

Background and Improvement of anti-bacterial properties of restorative materials to deal with microbes causing secondary caries of tooth has attracted interest of many researchers. Thus, in this study the antibacterial effect of zinc phosphate nanoparticles, synthesized with biological method, was investigated by adding it to glass ionomer cement against the Streptococcus mutans.
Synthesis of the nanoparticles was carried out using two main sources of zinc nitrate and diammonium hydrogen phosphate in presence of Enterobacter aerogenes. Furthermore, their antimicrobial effect was investigated by adding different concentrations of nanoparticles (0, 1, 2, 3, and 5%) to glass ionomer. In addition, bacterial cultures of 0.5 McFarland and its medium were added to the above mixture and were incubated in 37ºC. After 3, 6, and 24 hr they were cultured on agar plates to grow. In the end, the number of bacterial colonies grown on the plates was counted and compared.
Adding nanoparticles to glass ionomer improved its antibacterial effect and this effect enhanced when the concentrations of nanoparticles increased.
Synthesized nanoparticles are appropriate to be added to the glass ionomer cements because of their impressive effect on inhibiting the growth of bacteria and sharing same coloring with teeth.

Background and Cognitive impairment is one of the common chronic diseases among elderly people which has huge social and economic burdens on the society but few studies have been conducted in this topic in north of Iran. The aim of this study was to assess the association between physical activity and some demographic features with cognitive impairments in elderly people in Amirkola, Iran.
This cross-sectional study was a part of the ‘Amirkola Health and Ageing Project’ (AHAP) that was carried out in 1390 elderly in 2011-2012. To measure cognitive status, the Mini Mental Estate Examination (MMSE) was used. The Physical Activity Scale for the Elderly (PASE) was also administered to assess physical activity levels. Data was analyzed in SPSS V19 using t-test, Chi-square, Pearson correlation, and logistic regression.
A total of 1390 elderly was studied including 763 (54.9%) males and 627 (45.1%) females. In this study, 421 elderly (30.3%) had abnormal MMSE and 1085 cases (78.1%) had low physical activity score. The mean of PASE was higher in people with normal MMSE (P=0.000) and a significant positive correlation was observed between physical activity and MMSE (r= 0.117, P= 0.000). Physical activity was found to be an effective variable on cognitive impairments.
This study showed low frequency of cognitive impairments in elderly with higher levels of physical activity. This correlation was more considerable in females.

Background and Night time pain and paresthesia are the most common symptoms of carpal tunnel syndrome (CTS). Neuropathic pain and insomnia (due to night pain) accompanied by depression influence the quality of life, and response to treatment. So, this study aimed at evaluating concurrency of these disorders.
A descriptive cross-sectional study was done in 75 patients with CTS, referring for electrodiagnosis in Rafsanjan Ali-Ibn-Abitaleb Hospital, Iran. Demographic information was obtained and Beck Anxiety and Depression Inventories were administered. The findings were analyzed in SPSS V21. P values According to the findings, 11 (13.9%) patients with CTS had moderate depression while 17(21.5%) suffered from severe depression. Twenty six (32.9%) patients had moderate anxiety and 17 (21.5%) had severe anxiety. There was no significant association between the levels of depression and anxiety and disease severity. The levels of both depression and anxiety were significantly lower in patients who were employed and those with higher education.
The prevalence of depression and anxiety in patients with CTS was higher than general population.

Background and Sleep is one the main physiological parameters in circadian rhythm. Poor sleep is associated with many health consequences such as increased overall mortality and metabolic syndrome in adults and children. The aim of this study was to investigate the relationship between sleep and metabolic syndrome.
In a descriptive study, data of 2038 participants aged 20 to 70 years was collected from Yazd Health Study (YaS) using a researcher-made questionnaire. The metabolic syndrome was determined based on measuring waist circumference, triglyceride, HDL, blood pressure, and fasting blood sugar levels. Data was analyzed in SPSS V.18.
The participants included 44.4% males. The prevalence of metabolic syndrome in males and females was 34.6% and 49.1%, respectively. The lowest rate of metabolic syndrome was found in people aged 20 to 29 years (14.7%) and the highest rate was observed in those aged 60 to 69 years old (56.3%). The results showed that people with less than six hours sleep and more than ten hours were 2.5 and 3.5 times more likely to develop metabolic syndrome, respectively. Individuals with unwanted wake-ups –three times or more- (42%), having more than three nightmares (50%), taking three or more sleeping pills (80%), and people who had more than 60 minutes delay in falling asleep (31%) were more at risk of metabolic syndrome.
Considering the importance of enough sleep, sleep hygiene practices are necessary to improve the quantity and quality of sleep in order to prevent metabolic syndrome.

Background and Head trauma is amongst the major causes of death and morbidity caused by traumatic injuries. Assessment of trauma patients is an active process which includes initial (triage) and secondary assessments. Various triage tools are designed and used, but, so far no specific and accurate tool has been introduced for triage of head trauma. This study compared the effectiveness of ESI triage tool and nursing triage approach based on Roy Adaptation Model to predict the need for ICU admission in patients with head trauma.
A clinical trial was done in 400 patients with head trauma in Emergency Department, Mashhad Shahid Kamyab Hospital, 2016. Patients were selected using block randomization and based on the day of admission. They were allocated into receiving nursing care either through ESI triage or Roy Adaptation Model. Twelve hours after triage, patient's outcome were followed based on keeping them in ICU or ward admission. Finally, the margin of error was calculated and compared between the two instruments.
Kappa test did not show any significant difference between the ESI and Roy Adaptation Model triage in prediction for ICU admission at first place (P= 0.123). But, the Roy Adaptation Model was associated with significantly less errors in keeping the patient in ICU or ward admission (P = 0.012 ).
Compared with ESI triage, Roy Adaptation Model could result in fewer errors in predicting the consequences of head trauma patients.

Background and Industries are one of the main sources of producing wastewater accounting for 20% of water pollution. Treatment of dye wastewaters is one of the major challenges in textile industry. The aim of this study was to investigate the performance of advanced oxidation processes, Fenton-Peracetic acid and Photo-Fenton-Peracetic acid for removal of methylene blue (MB) dye from aqueous solutions.
We conducted an experimental study in which the effects of operating parameters such as pH (3-9), contact time (2-30 min), Peracetic acid concentration (5-50 mg/L), ferric chloride concentration (5-200 mg/L), and methylene blue concentration (5-100 mg/L) were investigated on the removal efficiency of MB dye in the presence and absence of ultraviolet radiation. The experiment was conducted in a batch reactor and the efficiency of method to remove color was measured using a spectrophotometer.
In current study the highest removal efficiency (99%) was attained by Fenton-Peracetic acid process under the optimized conditions as follows: pH 3, Peracetic acid concentration 30 mg/L, ferric chloride concentration 60 mg/L, methylene blue concentration 10 mg/L, and contact time of 30 min, but, the same amount of color was removed in shorter time (20 min) by Photo-Fenton-Peracetic acid process.
High removal efficiency of the Photo-Fenton-Peracetic acid process in a relatively short time, which is because of hydroxyl radical production, show that this process can effectively be applied to remove MB dye and can be considered as a suitable alternative to conventional systems for treatment of wastewaters containing similar organic matters.

Background and Aminoglycosides are broad-spectrum antibiotics that are often used in combination with other antibiotics for the treatment of severe S. aureus infections. This research aimed at investigating the phenotypic and genotypic evaluation of aminoglycoside resistance in clinical isolates of MRSA in Kerman, Iran.
During a one year period, a total of 57 MRSA isolates was collected from 130 isolates of S. aureus. MRSA isolates were tested for susceptibility to 13 antimicrobial agents using disc diffusion method. Then, the presence of aminoglycoside modifying enzymes (AMEs) was evaluated by multiplex polymerase chain reaction.
In the MRSA isolates, high resistance rates were observed for tetracycline, erythromycin, kanamycin and gentamicin. In fact, 73.7% and 68.4% of the isolates were found to be resistant to kanamycin and gentamicin, respectively. aac(6′)-Ie-aph(2″), aph(3′)-III, ant(4′)-Ia, and aph(2ʹʹ)-Id genes were detected in 40.3%, 15.7%, 12.2%, and 3.5% of the aminoglycosides–resistant isolates, respectively.
The prevalence of aminoglycosides resistance among MRSA isolates is rising, therefore, identification of resistance genes in order to achieve the exact pattern of resistance is helpful in preventing the spread of resistant strains.

Background and There is an increasing rate of drug resistance against trichomoniasis and current drugs used in treatment of this disease have many side effects, therefore, attempts have been made to explore alternative drugs favorably from natural sources. The present study aimed at evaluating the anti-Trichomonas effect of essential oil and that of nano-emulsion of Rosmarinus officinalis on the growth of Trichomonas vaginalis (T. vaginalis) in vitro.
T. vaginalis reference strains were cultured in modified TYM medium. The components of rosemary essential oil were determined by gas chromatography. In addition, cytotoxicity effects of essential oils and nano-emulsions prepared from this plant were evaluated against macrophage cell line (J774.A.1). Serial concentrations of 10, 25, 50, and 100 (μg/mL) were prepared from rosemary essential oil and nano-emulsion. Then growth inhibition rate of the parasites in different concentrations was done in triplicate within 1, 2, and 3 hours.
Rosemary essential oil and nano-emulsion had an inhibitory effect on the growth of Trichomonas and concentration of 100 μg/mL showed growth inhibition effect of 96.1% and 100% throughout 1,2 and 3 hours, respectively. Additionally, cytotoxicity assay against macrophage revealed no toxicity on the cells at 100 μg/mL.
According to the suitable anti-trichomonas activity of rosemary, this plant could be considered as a good candidate in treatment of Trichomonas infection, after complementary studies on animal model.

Background and The genus Vicia (Papilionaceae) contains 45 species in Iran. This investigation was designed to study the impact of extraction methods on total phenolic and flavonoid contents and antioxidant activities of V. hirsuta aerial parts.
In this experimental study the efficiencies of three extraction methods i.e. Maceration, Soxhlet, and ultrasonically assisted extraction were evaluated for the extraction of antioxidants. Antioxidant activities were investigated by four different methods. The total phenolic and flavonoid contents were also determined. Data analysis was done in GraphPad Prism 5.
Soxhlet extract showed highest amount of phenolic and flavonoids contents. In DPPH radical scavenging activity, soxhlet extract had a higher activity which was significantly different from other extracts (P 0.05). In iron chelating activity, maceration extract had the highest activity.
Extraction methods significantly affect antioxidant capacities and total phenolic and flavonoid contents. Soxhlet assisted extraction was chosen as the most efficient method.

Background and BCL-2 marker has an important role in mechanisms of apoptosis and dysplastic changes, malignancies, and the pathogenicity mechanisms in oral lichen planus (OLP). Current study aimed at investigating the expression levels of BCL-2 in epithelial and connective tissue adjacent in oral lichen planus.
In this case-control study, investigation of BCL-2 expression was performed in paraffin embedded tissue blocks of 20 cases of OLP (cases) and 20 cases of irritation fibroma (control) obtained from the Archives of Pathology Department in Dental School, Shahid Sadoughi University of Medical Sciences. Data was analyzed using SPSS V17 applying Chi-Square test and Fisher's exact test. The results were considered significant for a significance level of α=0.05.
There was no statistically significant difference in BCL-2 expression in the basal and parabasal layers of the epithelium between the two groups (P>0.05), but the difference was statistically significant for the connective tissue (P=0.0001).
This study showed that BCL-2 protein may not play an important role in the process of apoptosis in OLP, so, further investigations on other proteins in this process is recommended.

Background and Wild boars (Sus scrofa) are potential reservoirs for a lot of zoonotic diseases, so it is possible to transmit these infections to wild and domestic animals and also humans. This research aimed to survey the protozoan prevalence of Sus scrofa in Mazandaran Province, North of Iran.
In a descriptive cross-sectional study a total of 21 wild boars was captured beween December 2012 and March 2014. Faeces collected from the intestinal tracts of each animal was placed in appropriate fixative. Temporary staining with Lugol’s solution was performed in order to find the protozoan cysts and trophozoites. The stool samples were further studied using sedimentation and flotation methods. Then, fixed stool smears were examined by trichrome and Ziehl–Neelsen staining.
There were 21 samples of which 12 (57.14%) were found to be infected with one or more protozoan species. The prevalence of contamination with intestinal protozoan was as follows: 33.33% trophozoites and cysts of Balantidium coli, 28.57% oocysts of Eimeria spp., and 9.52% cysts of Giardia spp.
According to current findings, wild boars in Mazandaran province are infected with a lot of zoonotic protozoan, which create potential risks for other animals and people in the region.

Background and Drug-poisoning is amongst major health problems throughout the world. Evidence shows high prevalence of drug-poisoning in Iran. This study investigated the epidemiology of drug-poisoning death in central cities of Mazandaran province (Sari, Qaemshahr, Behshahr, Juybar, and Chhardangeh).
We conducted a cross-sectional analysis of all fatality records caused by drug-poisoning over a five-year period (2011-2016) in Sari Department of Forensic Medicine. Data was collected using a researcher-made questionnaire. SPSS V21 was applied for data analysis.
The cases included 31.1% females and 68.9% males. The majority of people (43.6%) aged 15-30 years. The most prevalent medicine were Aluminium phosphide (65.5%), Opium (24.3%), Ethylic alcohol (5.7%), and Tramadol (4.5%).
In this study, a high prevalence of drug toxicity was seen in young individuals, therefore, further investigations on psychological and social problems of young people are needed. Aluminium phosphide was found to be the most common type of drugs since it is found easily. Necessary measurements such as early diagnosis and patient’s participation could decrease the rate of mortality caused by drug poisoning.

Background and Healthy sexual function is a necessary component for creating a happy and successful life. Many therapeutic interventions are conducted in order to improve women’s sexual function and treatment of sexual dysfunctions. This study aimed to determine the therapeutic interventions conducted in Iranian women of reproductive age.
In this systematic review, IranMedex, Magiran, IranDoc, Cochrane Library, MEDLINE/PubMed, Scopus, and Google Scholar were searched up to February 2016. All clinical trials and interventions conducted for improving women’s sexual satisfaction and function in Iran were entered into the study. Finally, 12 articles which met the inclusion criteria were selected. Data from the studies was extracted to data sheets and qualitative analysis was conducted.
In 12 clinical trials 868 women in reproductive age were participated and most of the interventions were non-pharmacological and psychological treatments, often done through cognitive behavioral approach (41.6%). Other methods included PLISSIT model, sexual training, herbal medicines, and pelvic floor exercises.
There are few studies on improving women’s sexual satisfaction and function. Also, the diversity of interventions in Iran is more limited than that of other studies throughout the world. According to the importance and prevalence of sexual dysfunctions among Iranian women, and heterogeneity of information on this subject in previous studies, more appropriate clinical trials are required using standard tools and more culturally appropriate interventions.

Molecular epidemiology refers to the use of molecular tools in assessing the status of a cycle of a disease in a specific population. Currently, easy, fast, and high performance molecular tools are widely used in identifying parasites in clinical and biological samples. The aim of this study was to review molecular tools for better understanding of parasitic infection in taxonomic and epidemiological studies. Many researches have provided a variety of methods and markers for identification and evaluation of genetic diversity and elimination of taxonomic problems, especially at the level of species or subspecies of various parasites. Many of these studies are on the prevalence of concurrent infections with different species and subtypes or strains of a parasite. So far, different pieces of rDNA, mtDNA, and kDNA have been used for identification and phylogenetic analysis. If the purpose of a study is to determine intra-specific variations of the parasite, it is better to use sequencing ribosomal ITS1 and mitochondrial CO1. In addition, SSU rDNA and LSU rDNA are used in phylogenetic analysis and taxonomy. It can be concluded that new molecular tools and markers are good alternatives to traditional methods because in many endemic areas successful treatment depends on rapid and accurate diagnosis.

Leishmaniasis is a group of tropical diseases with high worldwide prevalence and difficulty in management. At present, the development of resistance and the increase of co-infected leishmaniasis with AIDS have become a serious public health problem. Thus, designing and discovery of effective and non-toxic drugs for the treatment of this disease is very urgent. Azole derivatives have displayed a wide range of biological activities. The pharmacological interest of azole compounds has been established to find new antileishmanial agents. The usefulness of some well-known azole antifungals has been also reported previously. Generally, azole antifungals have a common pharmacophoric portion namely N-phenethylazole and act by inhibiting the cytochrome P-450-mediated 14α-demethylation of lanosterol. Apart from azole antifungals with N-phenethylazole structure, a variety of N-aryl azoles and fused azole derivatives have been reported as antileishmanial agents. These compounds possess distinct structure and mechanism of action differing from those of azole antifungals. Thus, in this paper we reviewed the current application of N-aryl azoles and fused azoles for the design and development of new antileishmanial agents.