مجله دانشگاه علوم پزشکی مازندران
پیاپی 177 (مهر 1398)

The quality of life in patients with cancer is affected by cognitive changes after chemotherapy. There are different reports about the effect of cyclophosphamide as a chemotherapy agent on cognitive function. So, the present study aimed to investigate the effects of acute and chronic injections of cyclophosphamide on passive avoidance and novel object recognition memory in an animal model.

In this experimental study, 56 male mice (weighing 30±5g) were investigated in 8 groups, including a control group (saline) and a group that received cyclophosphamide with acute injection (single dose) and two similar groups with chronic injection (4 injections per week for 4 weeks) for passive avoidance test. In the next four groups the novel object recognition test was performed. Cyclophosphamide was injected at 50 mg/kg intraperitoneally and before training. In order to investigate the histopathology of the hippocampal tissue, the brains of the mice were removed after the tests. Data were analyzed applying independent t-test in SPSS.

Acute cyclophosphamide administration had no significant effect on the two types of memory, but in chronic injections, it decreased the passive avoidance memory (P<0.05), while it did not affect cognitive memory. Ischemic changes were observed in neurons CA1 to CA3 (Cornu Ammonis areas) and DG (Dentate Gyrus) hippocampal in chronic cyclophosphamide administration.

Cyclophosphamide was not found to affect all aspects of memory, and the avoidance memory impairment due to its chronic administration seems to be due to neurological damage to the hippocampus.

In this study, the effects of a mixture of deoxypodophyllotoxin/DPT and Juniperus communis L. on apoptosis and cellular inhibition were evaluated. Also, their cytotoxicity effects on prostate cancer cells (PC3 and DU145) and normal cells (HGFs), their anti-inflammatory effects, oxidation properties, and their effects on the expression of androgen receptors (AR) and clusterin (CLU) receptors were evaluated.

In this experimental study, the cells were cultured in DMEM f12 medium containing L-glutamine, penicillin, streptomycin, and 10% FBS. Morphological changes induced by reverse microscope were investigated 24, 48, 72, and 96 hrs after adding pure DPT and juniper extract at 10, 100, 500, 1000 μg/ml. Survival rate was assessed by MTT assay in all three cell lines. The rate of apoptosis in all cell lines was assessed by flow cytometric analysis. The expression levels of AR and CLU genes were evaluated by Real-Time PCR.

The 10, 100, 500, 1000 μg/ml of DPT and 500 and 1000 oncentrations of extract after 24 hours caused morphological changes in PC3 and DU145 cells and these changes intensified after 48, 72, and 96 hr. The MTT test showed significant decrease in PC3 and DU145 cell survival levels at 100, 500, and 1000 μg/ml (P<0.001). Also, the extract at 100 and 500 μg/ml significantly reduced the survival of PC3 and DU145 cancer cells (P<0.042).

Pure DPT and plant extracts have cytotoxic effects on PC3 and DU145 cells with minimal damage to normal cells.

The aims of this study were to evaluate the antibiotic resistance
of Healthcare-associated Methicillin-resistant Staphylococcus aureus (HA-MRSA) and Community associated MRSA (CA-MRSA)-resistant strains of Staphylococcus aureus strains and to investigate the frequency of different types of spa typing, SCCmec I, II, III, IV, V, and type IV, among the strains of MRSA isolated from clinical specimens of children in Tehran Children's Medical Center Hospital.

In this cross-sectional study, antibiotic susceptibility test was performed using Kirby-Baer method according to the CLSI guidelines. Presence of mecA, PVL, spa genes, as well as different types of SCCmec I, II, III, IV, V, and major subtypes of SCCmec IV were investigated using Multiplex PCR.

Among 133 clinical isolates of S. aureus, 70 (53%) were methicillin-susceptible (MSSA) and 63 (47%) were MRSA. The mecA and PVL genes frequency distributions among MRSA strains were 100% and 3.1%, respectively. In the present study, there were 5 SCCmec (I-V) types, indicating wide variations in the hospital investigated. In addition, high prevalence of SCCmec III (30.1%) and III + Iva (23.8%) was observed. Of 63 strains of MRSA, 46 were classified into 11 spa types. The most common type was spa t037 that was found in 53.9% (n= 34) of the strains.

High prevalence of SCCmec III + Iva and emergence of CA-MRSA strains in hospitals can be a serious warning to practitioners and infection control committees.

Background and

Antimicrobial peptides (AMP) are one of the most diverse antimicrobial compounds that have received much attention due to the development of drug resistance of pathogens to conventional antibiotics. But, few studies have evaluated anti-parasitic properties of AMP. The present study was conducted to compare the effect of a cecropin–melittin chimeric peptide (CM11) and metronidazole on Giardia lamblia trophozoite.

In this study, using MTT assay, the cytotoxicity of CM-11 peptide (0.5-32 μg/ml) and metronidazole (0.25-25 μg/ml) was investigated on Caco-2 cells and IC50 was calculated. Flow cytometry was used to determine the rate of induction of apoptosis by CM11 and metronidazole. The toxicity of peptide on G. lamblia trophozitis was evaluated in vitro under different conditions.

MTT results showed that the highest percentage of cytotoxicity in caco2 cells was seen at 32 μg/ml of CM11 peptide after 24 (84.3±1.2%), 48 (88.7±0.9%) and 72 (87±1.5%) hours. In metronidazole group, the highest cytotoxicity was observed in 20 μg/ml after 24 (35±2.3), 48 (39.3±1.2) and 72 (48.3±1.8%) hours. The highest concentrations of peptide (32 μg/ml) and metronidazole (20 μg/ml) showed 99.8±0.2% and 99±0.6% cytotoxicity effect, respectively. The cytotoxicity effect of peptide and metronidazole on G. lamblia attached to caco2 cells at highest concentrations were 99.7±0.1% and 99.5±0.3%, respectively.

This study showed that cecropin-melittin chimeric peptide could be an appropriate candidate for the treatment of giardiasis.

Nowadays, food flavorings are widely used in Iran in different food and beverage items without considering their potential threats. This research aimed at investigating directed mutagenesis caused by flavorings using the Ames Test.

Direct mutagenesis of five artificial food flavorings (vanilla, banana, orange, coconut, and lemon), from three different brands, was investigated using salmonella typhimurium microbial strains TA98 and TA100, all of which carrying selective mutation in histidine operon in form of (His-). After confirmatory tests of the strains, they were cultured on glucose minimal agar in presence of different concentrations of the flavors. After 48-72 hours of incubation at 37oC, in case of flavor mutagenicity and reverse mutation in the histidine operon, the colonies observed were counted.

Direct mutagenesis of the flavors was investigated in three consecutive runs of three different concentrations. According to the results, the number of colony count in each concentration did not exceed twice the number of negative control colony count, which was the mutagenic criterion in this test.

According to the results, no sign of direct mutation in form of base-pair substitution or Frame Shift mutation was observed among the specimens’ DNA in different concentrations of flavorings.

Burn patients are at high risk for thromboembolic events. According to recent studies, in most burn patients, standard dosage of enoxaparin cannot be effective in preventing thromboembolic events. The aim of this retrospective study was to evaluate the compliance of enoxaparin for the prevention of thromboembolic events in burn patients with the standard guidelines for management of burn in Sari Zare Hospital, Iran.

In this study, we reviewed the medical records of 61 burn patients admitted to Sari Zare Hospital for six consecutive months (2016) who had received enoxaparin. Prescribed dose and monitoring at the time of administration of enoxaparin were compared with standard guidelines for management of burn.

The mean age of patients was 47.37±15.6 and they were mainly male (73.8%). All patients received enoxaparin subcutaneously for prevention of thromboembolic events. Prophylactic dose was in accordance with recommended dose in 57.3% of the patients. Active anti-factor was not evaluated in any of the patients with body mass index (BMI) outside the normal range. The Platelet count was evaluated in all patients at the beginning and in 98% during the treatment. Drug interactions were reported in less than 10% of the patients with no side effects.

In most burn patients with normal BMI, the administered dose of prophylactic enoxaparin was not in accordance with the recommended dose. In patients out of normal range, the dose was not adjusted based on BMI. This could increase the risk of thromboembolic events or bleeding in these patients.

Uremic pruritus is a common complication in patients with chronic kidney disease, for which different treatments are applied. This study aimed to compare the effects of Zinc sulfate with Hydroxyzine in reducing pruritus in hemodialysis patients.

In this cross over randomized trial, 100 hemodialysis patients with uremic pruritus who met the study inclusion criteria were selected and randomly divided into two groups. The first group was treated with Zinc sulfate and the second group received Hydroxyzine for three mounts. After two weeks washout period, the treatment regimens were swapped. The severity of pruritus in patients was evaluated before, one, two, and three months after the interventions using the visual analogue scale (VAS).

The study showed that the severity of itching caused by Zinc sulfate and Hydroxyzine were similar at the onset of treatment (8.2±2.1 vs. 7.9±2.3), but at month three, the severity of pruritus in the group that received Zinc sulfate (3.7±2.4) was significantly lower compared to the other group (5.6±2.9) (P<0.0001).

Zinc sulfate compared was found to be more effective in reducing pruritus in hemodialysis patients and it can be used as an independent treatment in management of pruritus, however, for better results at least a three month treatment period is recommended.
 
(Clinical Trials Registry Number: IRCT201411252954N5)

Fear of pain is one of the main reasons for refusing surgical hemorrhoidectomy among patients with hemorrhoids. This study investigated the effect of Diosmin on post-hemorrhoidectomy pain.

A single-blind randomized clinical trial was performed in 92 patients undergoing hemorrhoidectomy. They were randomly divided into two groups; the intervention group (n=46) received Diosmin 500 mg daily, and the placebo group (n=46) received a tablet daily. Both groups were examined after a week. Duration of hospitalization, return to work, and time of complete recovery and pain were also examined. Data analysis was done in SPSS V18.

The mean age of patients was 37.55±12.21 years. In both groups, distribution of population was completely homogeneous in terms of age (0.833), gender (1.00), degree of hemorrhoids (0.538), mucous secretion (0.514), duration of hospitalization (0.821), return to work (0.754), complete recovery (0.631), and postoperative bleeding (0.557) showing no significant relationship between the two groups (0.557). The mean pain intensity was 3.41±1.292 in intervention group and 4.65±1.370 in the placebo group which showed a significant difference between the two groups after the intervention (P=0.000).

Diosmin can be used as a safe drug with minimal side effects to control post-hemorrhoidectomy pain.
 
(Clinical Trials Registry Number: IRCT20180717040509N1)
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Physiological changes in pregnancy cause profound challenges to mental health. The aim of this study was to investigate the effect of counseling based on Information-Behavioral Motivation Model on health promoting lifestyle behaviors and psychological well-being in overweight and obese pregnant women.

This randomized clinical trial was performed in 137 pregnant women with a BMI ≥25 and 12 to 16 weeks gestational age. The participants were divided into two groups of counseling (n=67) and routine care (n=70). The counseling group attended four sessions of counseling based on the Information-Behavioral Motivation Model, while the other group received routine care. Demographic information was recorded and Health-Promoting Lifestyle Profile [HPLP II] and Ryff's Psychological Well-being scale were completed before and 8 weeks after the intervention. Descriptive and inferential tests, ANOVA, and Multivariate Covariance Analysis (MANCOVA) were used to analyze the data.

Using the ANCOVA and MANCOVA test after adjusting the pre-intervention scores in both groups, the mean scores for health-promoting lifestyle behaviors and psychological well-being were found to be higher in intervention group compared to those in the group that received routine care (158.72±24.15 vs 141.29±24.88, P <0.001, d= 0.77 and 75.92 ± 7.87 vs. 72.17 ± 11.88, P= 0.04, d= 0.23, respectively).

Consultation based on Information-Behavioral Motivation Model improves health-promoting lifestyle and promotes level of mental well-being.
 
(Clinical Trials Registry Number: IRCT20120125008822N3)

 Illness perception can affect self-care, mental anxiety, and other health outcomes in individuals. Current study aimed to investigate the effect of Leventhal’s Self-Regulatory Model on illness perception in women with Gestational Diabetes Mellitus (GDM).

A randomized controlled clinical trial was performed in women with GDM admitted to prenatal department of Rasht Alzahra Hospital (March-September 2018). Patients were assigned into two groups of control (n=40) and intervention (n=40) using randomized block design. Demographic characteristics were recorded and Illness Perception Questionnaire (IPQ) was completed in both groups. Leventhal’s Self-Regulatory Model was applied in intervention group within three sessions. The IPQ was completed in both groups after the intervention and four weeks later.

The scores for illness perception were not found to be significantly different between the two groups before the intervention (P= 0.19). Immediately after the intervention, the mean scores of illness perception were 38.09±6.8 and 43.9±8.6 in intervention and control groups, respectively (P=0.003).One month after that, the mean scores of illness perception in the intervention group (39.3±5.8) were significantly lower than the control group (45.7±6.9) (P<0.001).

Using the Leventhal’s self-regulatory model could improve illness perception of women with gestational diabetes, therefore, it could be applied in these women to avoid further consequences.
 
(Clinical Trials Registry Number: IRCT20171103037191N2)

Puberty is one of the most critical stages in the life of every girl in adolescence. The purpose of this study was to determine the impact of peer education on girls' knowledge and practice about puberty.

In this semi-experimental study, 10 eighth-grade classes were selected from ten high schools in Shahroud, Iran 2018, using multi-stage sampling. Random assignment of schools to two groups of control and intervention was done. A total of 217 students enrolled in this research. Demographic characteristics were recorded and students completed a researcher-made questionnaire on puberty before, immediately after, and one month after the intervention. The intervention group received peer education on puberty by trained individuals for one month. Data were analyzed using descriptive statistics. The alpha level of 0.05 was considered significant.

There were no significant differences between the two groups in the mean scores for knowledge and practice before the intervention (P= 0.17). The mean scores of knowledge and practice in intervention group were 28.18±3.85 and 121.59±10.32 immediately after the intervention, and 31.91±3.69 and 130.37±8.07 one month after the intervention, respectively which were significantly higher than those of the control group (P= 0.001).

Collaborative nature of peer education makes it an appropriate choice for educating puberty issues to adolescents.
 
(Clinical Trials Registry Number: IRCT20180209038675N1)

Non-cardiac chest pain (NCCP) is a common entity with negative effects on quality of life that places a large financial burden on health systems. This study aimed at investigating esophageal motility disorders in patients with NCCP.

This cross-sectional study was conducted in 101 patients with recurrent chest pain without any cardiac disease, attending Ahvaz Imam Khomeini Hospital in a one-year period. Those who had no evidence of gastroesophageal reflux disease (GERD) on upper endoscopy and 24-hr esophageal pH monitoring were referred for conventional esophageal manometry.

From 101 patients, 51 showed endoscopic or pH-metric evidences of GERD. Manometric evaluation was done in 50 patients, including 27 males and 23 females (mean age: 44.2 years, 26-68 years old). Half of the cases (n=25) had abnormal motility disorders, including nonspecific esophageal motility disorder (20%), nutcracker esophagus (10%), diffuse esophageal spasm (8%), hypertensive LES syndrome (8%), and ineffective esophageal motility (4%). Esophageal motility disorders were found to have no significant associations with weight and age (P=0.125 and P=0.285).  The rate of esophageal motility disorders were lower in non-smokers (P=0.019).

Esophageal motility disorders and GERD are frequent in patients with NCCP. Further studies are needed to establish a cause-effect relationship.

Influenza viruses annually spread around the world in seasonal epidemics. The A/H1N1 virus causes more severe conditions compared to other types of Influenza A. This study is an epidemiological survey of influenza A/H1N1 virus in patients attending health care centers in north of Iran during 2013-2017.

Sampling was done in 3037 patients. Influenza-RNA was extracted from the samples using Viral RNA/DNA Kit PureLinkTM. Identification of influenza A/H1N1 virus
was done using special primers and probes (Invitrogen), and Quantitative Real Time PCR System (SuperScript III Platinum).

The samples were obtained from both males (39.9%) and females (60.1%). Patients aged 31-40 years of old included the majority of samples. Influenza A/H1N1 positive samples were seen more in patients aged 61-70 (18.51%) (14.55%). Out of the 442 confirmed cases of influenza A/H1N1, 23 (5.88%) deaths were reported.

Influenza A virus is constantly evolving by mutation or by reassortment. It evolves rapidly, and new strains quickly replace the older ones, therefore, new vaccines should be developed for immunization against new strains of influenza.

In order to move towards excellence, hospitals should adopt new management techniques such as organizational excellence model. The purpose of this study was to assess the performance of an educational hospital applying organizational excellence model and operational planning.

This descriptive-analytical study was conducted in Sari Imam Khomeini Hospital, 2018. The research population included all hospital managers and nurses. Data were collected by EFQM excellence model. Its validity was approved and its reliability was 0.92 using Cronbach's alpha coefficient. Data were classified according to IPOCC approach into input, process, output, control, and context and analyzed in SPSS V18.

The scores for empowerment and results sections were 319.82 (63.96%) and 313.38 (62.67%), respectively. The highest distribution of components and scores according to IPOCC approach were in results (40.2%) and structure (3.25 ±0.44). One-way ANOVA showed significant differences between the dimensions of IPOCC (P<0.001).

The hospital investigated, was found to be in a relatively appropriate condition according to EFQM excellence model. Therefore, having a systematic perspective and proper control over therapeutic processes and contextual aspects such as organizational culture along with processes, structures, and results are suggested to balance the standards.

Contamination of groundwater with colored and toxic wastewater causes many environmental problems and has adverse effects on human health. This study aimed at coating a nano polyaniline polymer layer on the surface of sawdust and preparing polyaniline sawdust composite (Pan/SD) via chemical polymerization of aniline monomer onto sawdust in aqueous solutions and removal of Rhodamine B dye.

In an experimental study, polyaniline was synthesized by oxidation with ammonium persulfate. In order to find out the optimum dye removal conditions, the effects of some major parameters, including pH, contact time, initial dye concentration, and absorbent dose were studied. For treatment of the adsorption data, both Langmuir and Freundlich isotherm were employed. Also, Thermodynamic and Kinetic studies were performed.

The study showed that the aniline/sawdust nanocomposite can absorb more than 94% of  Rhodamine B in Rhodamine B concentration of 10 mgL-1, optimum adsorbent 1 gL-1, pH = 5, and contact time 5h. Absorption data were more fitted with Freundlich isotherm. Thermodynamic studies showed that the removed dye was spontaneous, endothermic and chemical sorption that followed second order kinetic model.

The adsorbent introduced here, is an insoluble absorbent in water without secondary pollution and a very efficient adsorbent for removal of Rhodamine B from aqueous solutions and a layer of conductive nano-polymer onto the sawdust can remove a high percentage of Rhodamine B from aqueous environments.

Heavy metal pollution is among the most serious environmental issues that is caused directly or indirectly through human activities or natural sources. Alagol wetland is one of the most important ecosystems in Iran which is affected by numerous agricultural and industrial development programs.

A descriptive cross-sectional study was performed in summer and autumn 2017. Heavy metal contamination (nickel, cadmium, and lead) was investigated in 50 samples from five different zones of water and sediment of wetland. Zoning was done using GIS and data analysis was performed applying ANOVA, Tukey’s test, and multivariate analysis (CA).

Average concentrations of cadmium, lead, and nickel in water were 0.013±0.02, 0.86±0.44, and 0.164±0.55 in summer and 0.021±0.03, 0.658±0.36, and 0.334±0.65 in autumn, respectively. The average concentrations of cadmium, lead, and nickel in sediment were 0.19±0.005, 2.103±0.011, and 0.489±0.102 in summer and 0.11±0.003, 1.796±0.261, and 0.353±0.2040 μg/kg dry weight in autumn, respectively.

The level of contamination was found to be higher in western zone. The study showed high impact of human resources on lead and cadmium contents but nickel content was more of natural resources. The amount of metals measured were lower than the global standards. Industrialization, increasing rate of international road transportation, and agricultural activities caused high concentrations of metals in Alagol Wetland.

Anatomy is a branch of science that deals with different parts of human body and its organizational structure. It has various goals, such as insight into the divine perfection and understanding the causes of diseases and their treatments. Anatomy in the Islamic era included physiology too. This research aimed at providing an overview on anatomy in the Reference Materials of Persian Medicine.

A qualitative study (content-analytic library research) was performed based on the books of Persian medicine. This study was conducted at several stages; finding the keywords, searching in reference texts of Iranian-Islamic medicine, in history books and Islamic encyclopedias, and in Persian and Latin electronic banks, then sorting, organizing, and comparing the information.

Anatomical knowledge is prerequisite to treatment and surgery. The works of Muslim scientists on anatomy, like the Europeans, were found to be influenced by the works of Galen. According to evidence, Muslim doctors performed autopsy and were great surgeons.

The basis of the new anatomy enhanced by Vesalius is similar to the Iranian-Islamic anatomy that was introduced to Europe after revising the texts of Galen. Considering the holistic viewpoints in Persian medicine, further research is needed to adapt that to modern medicine.

Temporomandibular joint (TMJ) disorders are abnormalities that interfere with the shape or normal functioning of the joint, characterized by a group of clinical symptoms including pain, joint sounds, and limitation or deviation when opening the mouth. Considering the effect of skeletal relationships of the jaw on the shape, size, and morphologic variations of the condyle and its changes in TMJ, current study aimed at investigating radiographic changes in TMJ in patients with skeletal class II and III in Sari, Iran 2015-2018.

In a retrospective cross-sectional study, 249 angle class II and 66 class III subjects were studied. After determining the skeletal relationship class using cephalometric radiographs, TMJ bone changes were investigated in panoramic images. Data analysis was done applying Chi square, T test, and logistic regression in SPSS V16.

There was a significant difference in flattening distribution between class II and III subjects in patients aged 26-30 years old (P=0.036) and the prevalence of this disorder was higher in patients with skeletal class III. There were no significant differences between patients with skeletal class II and III in the prevalence of flattening, erosion, hypoplasia, and hyperplasia. TMJ disorders were significantly more frequent in females (P=0.035).
Conclusion In this study, the most and least frequent disorders were erosion after flattening and hyperplasia, respectively.

Helicobacter pylori is a gram-negative, micro-aerophilic, and spiral-shaped bacillus. Infection with this bacterium can lead to gastritis, ulcers, and even gastric cancer. This study was conducted to evaluate the presence of the cagA gene among patients with gastritis and gastric cancer.

This study was performed in patients with gastritis (n=40) and gastric cancer (n=40). Presence of H. pylori infection in gastritis specimens and in cancerous tissues was investigated by urease test and Giemsa staining, respectively. Using PCR, 16S rRNA and cagA genes were investigated.

Pain and weight loss were the most common complaints of patients. Dyspepsia and duodenal ulcer were the most frequent endoscopic findings. According to pathologic results, intestinal-type G1 adenocarcinoma was detected in most cases. All positive-H. pylori cases were also positive for 16S rRNA. The cagA gene in patients with gastritis and stomach cancer was present in 13 (32.5%) and 11 (27.5%) cases, respectively.

Compared to other studies, low presence of the cagA gene in Qom could be an indication of less virulent strains in this province, but, further studies are recommended to evaluate other genes.

Couples' communication patterns is of great importance in resolving marital conflicts. These patterns include mutual constructive communication, mutual avoidance communication, and demand-withdrawal communication. The present study aimed at investigating the factors associated with Iranian couples' communication patterns.

A scoping review was performed at five stages; 1-designing the research question 2- searching and extracting research studies 3- selecting relevant studies 4- organizing and summarizing the information, 5. reporting the results.

In this scoping review, 18 articles were selected from 130 studies. The factors affecting couples' communication patterns were classified into four categories: 1- spiritual well-being and spirituality, 2- marital and sexual satisfaction, 3- marital compatibility, and 4- love styles.

Some factors, including spiritual well-being and spirituality, marital satisfaction and sexual satisfaction, marital compatibility, and love styles were found to affect couples' communication patterns. Seemingly providing ways to enhance couples' communication patterns towards a mutual constructive pattern is necessary to prevent marital problems and conflicts, and experiencing effective and efficient relationships.