مجله دانشگاه علوم پزشکی مازندران
پیاپی 200 (شهریور 1400)

Cataract is a common disease and oxidative stress is recognized as a major cause in its development. The aim of this study was to investigate the protective effect of Phyllanthus emblica L., Acorus calamus L., and Chelidonium majus L.  against cataracts according to the antioxidant properties of these plants in rats.

In this study, 30 neonate rats (8-10 days) were divided into five groups; group 1 (control group) received normal saline on day 10. In other four groups, subcutaneous injections of sodium selenite (30 µmol/Kg) were done to induce cataract on day 10.  In group 2 no other intervention was done. Groups 3, 4 and 5 received IP injections of Phyllanthus emblica L., Acorus calamus L. and Chelidonium majus L. extracts (400 mg/kg), respectively on day 9-12. On day 17, morphological examination of rats’ lenses were performed and on day 30 the rats were anaesthetized and their lenses were removed. The contents of glutathione and malondialdehyde were measured in lens tissue. DPPH and flavonoid content tests were also done on plants’ extracts.

P. emblica, C.majus, and A.calamus had the highest amount of antioxidant compounds, glutathione level in lens tissue, reduction in cataract grade, and the highest eye protection compared to the sodium selenite group, respectively. Also, the content of malondialdehyde were the lowest in groups that received P.emblica, A.calamus, and C.majus compared to the control group.

P. emblica has considerable protective effect on cataract in rats.

One of the most common complications of diabetes is the disorder and defect in healing of diabetic wounds. Sambucus ebulus has anti-diabetic, anti-inflammatory, and antioxidant effects in repairing acute skin wounds. The present study was performed to investigate the effect of alcoholic extract of Sambucus ebulus fruit on wound healing in diabetic male rats.

This experimental study was carried out in 45 male rats. Thirty rats were randomly divided into two groups (n=15), 30 days after induction of diabetes and the rest were considered non-diabetic. The groups included normal wound, diabetic wound, and diabetic wound group treated with 5% Sambucus ebulus fruit extract. Sampling was performed at days 7, 14, and 21 after wounding. Assessments included wound closure rate, histological (collagen density) and stereological examinations, expression of genes involved in repair, regeneration and angiogenesis (TGF-β, bFGF, VEGF), and inflammatory genes (TNF-α and IL-1β) using qRT-PCR.

Wound closure rate, new epidermis and dermis volume, total fibroblast cells, and collagen deposition significantly increased in treated group compared with diabetic control group (P<0.05). The expression of genes, were found to be significantly higher in treatment group than the diabetic control group (P<0.05). Findings showed a significant decrease in expression of inflammatory genes and number of mast cells in treatment group compared with the diabetic control group (P<0.05).

The 5% fruit extract of Sambucus ebulus, with anti-inflammatory and antioxidant effects, showed great effects on healing process of diabetic and chronic wounds.

Alpha-pinene (α-pinene) is a bicyclic monoterpene present in essential oils of some aromatic plants. α-pinene is involved in modulation of some neurophysiological processes in animals. This study assessed the effect of intra-CA1 administration of α-pinene on spatial and passive avoidance learning and memory, and induction of long-term potentiation (LTP) in hippocampal CA1 region.

Male Wistar rats were cannulated in the CA1 area of hippocampus. Then, α-pinene (0.1, 0.2, and 0.4 µg) was injected in four consecutive days. Passive avoidance and spatial learning and memory were assessed by shuttle box and Morris water maze (MWM) tasks, respectively. Also, in vivo recording of field excitatory postsynaptic potentials (fEPSPs) in hippocampal CA1 region was done.

In MWM test, α-pinene decreased latency time and travelled distance to find the hidden platform (P<0.05). In the shuttle box, α-pinene increased the step thought latency and decreased the time spent in dark chamber of maze compared to the control group (P<0.001). There were no significant differences in induction of LTP in the CA1 area of the hippocampus between the controls and α-pinene group (P<0.05).

Intra-CA1 administration of α-pinene affected learning and memory of rats. However, α-pinene did not induce significant alteration in induction of LTP in hippocampal CA1 region.

Autophagy is lysosomal degradation pathway that contributes to tumor development through metabolic support, especially at final stages. The purpose of this study was to evaluate the effect of 12 weeks endurance training on autophagy-related gene expression levels in tumors of breast cancer-bearing BALB/c mice.

Twenty-two female BALB/c mice were randomly divided into control (n= 11) and experimental (n= 11) groups. Breast cancer was induced by injecting MC4-L2 cancer cells into the right dorsal mammary fat pad. The experimental group underwent training protocol for 12 weeks. Expression levels of autophagy-related genes were measured by real-time PCR and quantified bymethod. Data analysis was done applying Student t-test.

Endurance training led to significant decrease in tumor weight (P= 0.038) and volume (P= 0.043) in experimental group compared to the control group. Expression levels of Beclin1 (11%), Atg7 (53%), p62 (37%), gabarapl (76%), LC3-I (35%), and LC3-II (62%) in tumors of experimental group were lower compared to the controls. In addition, training protocol resulted in a decrease in LC3-II/LC3-I ratio (42%) and increase in p62 expression level (157%) (all P< 0.05).

Endurance training-induced reduction in tumor weight and volume was coincided with substantial reduction in expression levels of autophagy-related genes. This may suggest that beneficial effects of endurance training in breast cancer, at least in part, could be mediated through suppression of autophagy process in solid tumors.

ANGPTL3, a protein secreted by the liver, is involved in regulating fat and glucose metabolism. In this study, we investigated the relationship between serum ANGPTL3 levels and VO2max, body composition, and markers of metabolic syndrome. Also, we studied the effect of interval training on this factors in women who have overweight or obesity.

In this quasi-experimental study, 40 sedentary females were assigned into three groups: (1) Control / without exercise (n=13, average age: 28.5 years, BMI=30. 2 kg/m2), and experimental groups; (2) Moderate intensity interval training (n=13, average age: 30.1 years, BMI= 31.2 kg/m2), and (3) High intensity interval training (average age: 27.8 years, BMI= 30.9 kg/m2). The experimental groups participated in selected interval trainings for eight weeks. Blood samples were taken 48 hours prior to the first training session and 48 hours following the last training session and study variables were measured in all participants.

The findings revealed significant positive correlations between ANGPTL3 and BMI (P= 0.009), ANGPTL3 and Insulin (P= 0.027), ANGPTL3 and total cholesterol levels (P= 0.004). After eight weeks of interval training, we observed significant decrease in levels of ANGPTL3 (P= 0.021), triglyceride (P= 0.012), total cholesterol (P= 0.010), TG/HDL (P= 0.002), insulin (P= 0.020), insulin resistance index (P= 0.014), body fat percentage (P= 0.036), and BMI (P= 0.001) in experimental groups.  VO2max (P= 0.041) and HDL levels (P= 0.039) also showed significant increase in these groups.

It seems that high-intensity interval exercises reduce ANGPTL3 levels and could be useful in preventing metabolic syndrome in women who have overweight or obesity.

Phototherapy is the most common treatment for hyperbilirubinemia. Foot reflexology can possibly be suitable for reducing bilirubin levels by affecting meconium excretion. The aim of this study was to compare the effect of foot reflexology massage and whole body massage on bilirubin serum levels in neonates with hyperbilirubinemia.

In this randomized clinical trial, 90 neonates undergoing phototherapy admitted to the neonatal ward in Rafsanhan Hospital were selected using convenience and purposive sampling. The samples were divided into two intervention groups and a control group. The intervention groups, in addition to phototherapy, received massage therapy or foot reflexology massage three times daily for 20minutes over two consecutive days.The control group received only phototherapy. Demographic characteristics were recorded and serum bilirubin levels were measured before, 24, and 48 hours after the intervention.

Before the intervention, the mean bilirubin levels were 18.39±3.15, 18.51±2.24, and 18.23±2.44 in foot reflexology group, massage therapy group, and controls, indicating no significant differences between the three groups (P=0.923). But, 48 hours after the intervention, the mean bilirubin levels showed significant differences between the foot reflexology group (8.20±0.96), massage therapy group (8.67±0.68), and control group (9.33±1.22), (P<0.001). The post hoc test showed that foot reflexology could significantly reduce the mean bilirubin level compared with massage therapy and no intervention (P<0.001). Compared to the control group, the effect of massage therapy was significantly higher on reducing bilirubin level (P=0.027).

  It seems that foot reflexology is more effective in reducing neonatal bilirubin level than massage therapy. However, nurses could use both foot reflexology and massage therapy as two non-pharmacological methods to treat neonatal jaundice along with phototherapy.

Cancer is a group of disorders with high mortality. Evaluating cancer patientschr('39') perceptions regarding their quality of life is of great importance in observation of these people. The current cross-sectional study aimed to measure health-related quality of life in patients with late-stage cancer and to elicit the components representing greater functional limitations.

Forty patients (29 women and 11 men, mean age: 55.8 years) at late-stage multiple-organ cancer attending for radiation therapy were interviewed. We used the Russian version of 36-Item Short Form Health Survey (SF-36), consisting of 36 multiple-choice questions divided into eight subscales.

The participants reported impaired health-related quality of life in all eight aspects, although the scores were above the average value determined for general population. Major disabilities were lying within domains reflecting social functioning (56.88±14.14) and onechr('39')s ability to perform life roles in the light of cancer impacts on emotional health (54.17±30.84).

This research reinforces the importance of psycho-oncology services and social support for cancer survivors besides antitumor therapy. Meanwhile, the quality-of-life assessment could be useful for clinicians in terms of cancer treatment and choosing appropriate rehabilitation strategy. Our findings may have implications for public health and future research.

Musculoskeletal disorders are among the most common causes of injury and disability. Farm workers are at higher risk for these disorders due to hard physical work. In this study, the prevalence and factors related to musculoskeletal disorders were investigated in paddy workers in Golestan province, 2020.

The samples of this cross-sectional study were 220 people who were selected by cluster sampling. Data, including demographic and occupational information, and the prevalence of work-related musculoskeletal disorders were collected using the Persian version of Dutch Musculoskeletal Disorders (DMQ) and analyzed in SPSS V25.

The mean age of participants was 46.28 years and 163 (74.1%) were men. The highest frequent musculoskeletal pain was reported to be low back pain in the past year and past week (58.6% and 40.5%, respectively). Significant direct relationships were observed between age and total health (r= 0.141), musculoskeletal health (r= 0.381), and low back pain (r= 0.261). Findings showed significant differences between the scores of men and women in performing duties, work load, work schedule, breaks, and working condition (P < 0.05).

Providing educations to paddy workers and mechanizing their activities could decrease the severity of exposure to risk factors for musculoskeletal disorders.

Factors associated with menstrual irregularities are highly important. This study aimed to determine the association between age at menarche and menstrual irregularities in reproductive period.

This prospective longitudinal study, was done in women participating in Tehran Lipid and Glucose Study who did not reach menarche at the time of enrollment, but their age of menarche was recorded later during follow-up visits. The subjects were divided into three groups based on the age of menarche: 1- menarcheal age< 11 years; 2- menarcheal age 11-15 years, and 3-menarcheal age>15 years. The odds of menstrual irregularities were compared between these groups considering group 2 as reference. Statistical analyses were performed in STATA V13.

The odds of menstrual irregularities in women of group 1 was two times higher than those in group 2 (OR = 2.0, 95% CI: 1.1-3.8) that was 2.2 times higher (OR = 2.2, 95% CI: 1.1-4.2) after adjusting for age and body mass index.

Menarcheal age <11 years increases the risk of menstrual irregularities in reproductive women and should be considered as an influential factor in assessment of women with menstrual irregularities.

Sexual self-efficacy as one of the major issues of sexual health is influenced by various individual and interpersonal factors in different socio-cultural contexts. The aim of this study was to investigate sexual self-efficacy and related factors in reproductive-aged diabetic women.

This cross-sectional study was conducted in 410 diabetic women attending endocrinology centers affiliated to Mazandaran University of Medical Sciences, 2019-2020. The participants were selected by simple random sampling. Data were collected using Vaziri sexual self-efficacy questionnaire, the Female Sexual Function Index (FSFI), ENRICH Marital Satisfaction Scale, and Goldberg Big Five personality traits. Data were analyzed applying Independent t-test, ANOA, Pearson correlation coefficient, and Backward Stepwise Regression.

The mean score for sexual self-efficacy was 15.93±5.70 (95% CI: 15.37-16.48). Multiple linear regression showed that spousechr('39')s education (β= 1.27, P= 0.026), spousechr('39')s age (β= -0.09, P= 0.013), conscientiousness (β= 0.09, P= 0.014), occupation (β= -2.26, P= 0.022), satisfaction from socioeconomic class (β= 0.93, P= 0.024), sexual function (β= 0.23, P< 0.0001), marital satisfaction (β= 0.06, P< 0.0001), and taking antidepressants (β= -1.13, P= 0.051) explained 59% of the variance of sexual self-efficacy score.

Various sociodemographic and socioeconomic factors affect the sexual self-efficacy of diabetic women in reproductive age, so, it is necessary to use a multi-disciplinary approach in providing sexual health care services for these women.

Parkinsonchr('39')s disease (PD) is a chronic neurological disorder. Prevalence estimates of the disease are pivotal for planning and appropriate allocation of health care. The present study was conducted to investigate the prevalence of PD and its geographic variations in Iran.

In this cross-sectional study, the prevalence of PD in different provinces was estimated using the frequency of specialized drugs prescribed per 100,000 people. Then, geographical distribution of the disease was determined in Iran.

In this study, the prevalence of Parkinson’s disease in general population and >50 years old were 50.4 and 261.1 in 100,000 people, respectively. In general population, the lowest and highest PD prevalence were seen in Hormozgan province (15.7/100,000) and Isfahan province (96.9/100,000). Also, in those >50 years old the lowest PD prevalence was found in Hormozgan province (114.2/100,000) and the highest was observed in Isfahan province (449.5/100,000).

PD prevalence in >50 years old was lower in Iran than that in western countries, but it is somewhat comparable with PD prevalence reported in developing countries in Asia. In Iran, the prevalence of PD is considerably different in various regions.

Tinnitus is the perception of sound without external acoustic stimuli that has a great impact on quality of life. This disorder can affect sleep, daily activities, and social functioning. It also entails great costs to affected individual and society. Despite many studies of modern medicine, the exact pathophysiology of tinnitus is unknown. Hence, there is increasing attention to complementary medicine for management and control of the disease. The purpose of this investigation was to study the sources of Persian medicine for the causes of tinnitus to establish an appropriate model for its prevention and treatment.

We conducted a qualitative study (summative content analysis) and analyzed Persian medicine books and electronic databases.

One of the most important causes of tinnitus is accumulation of waste products and winds in ears and brain due to mistemper, indigestion, participatory diseases, formation of ripples and their movement in brain vapors, and stimulation of auditory nerve. In order to prevent and treat tinnitus, Iranian medicine places great emphasis on the six core pillars for a healthy life.

It seems that lifestyle modification could be of great help in preventing tinnitus and its management could also be done using methods that are associated with less complications.

Preliminary Hazard Analysis (PHA) is one of the methods to identify significant safety areas which provides an initial assessment of hazards and determines requisite hazard controls and follow-on actions. The purpose of this study was to investigate the waste status and perform a semi-qualitative risk assessment of Coronavirus transmission through waste management system in Sari Imam Khomeini Hospital using PHA and providing appropriate solutions.

This descriptive-analytical study was performed in Sari Imam Khomeini Hospital, 2020. PHA was conducted to identify and assess the risk of Coronavirus transmission at different stages of hospital waste management.

The waste produced in the hospital included infectious (98.09%), pharmaceutical and chemical (1.2%), sharps (0.69%), and normal wastes (0%). Plastics and organic materials accounted for the largest percentage of waste. Preliminary Hazard Analysis showed 35 potential risks for Coronavirus transmission, including waste collection (n=12), waste production, storage, and separation at source (n=11), and temporary storage and maintenance (n=6).

According to current study, reducing the risk of Coronavirus transmission in hospital waste management system, requires necessary trainings and awareness of healthcare personnel, especially hospital cleaning staff.

Human papillomavirus (HPV) infection is the main cause of cervical cancer. Awareness of the prevalence of different HPV genotypes in Iran will facilitate implementation of national prevention and vaccination programs. The aim of this study was to investigate the prevalence of HPV infection and the association of different genotypes with Pap smear results.

In this cross-sectional study, 502 married women attending Central Laboratory of Academic Center for Education, Culture, and Research in Mashhad were selected by non-probability easy sampling in 2018-2019. Cervical cytology specimens were examined for 32 different HPV genotypes using PCR and hybridization. Descriptive statistics, Chi-square and Fisherchr('39')s exact tests were used to analyze the data.

Out of 502 samples 26.5% were infected with HPV. The most common genotypes in all HPV+ samples were the low risk genotype 6 (35.3%) and the high risk genotype 16 (17.3%). According to findings, HPV infection and the HPV genotype were significantly associated with progression of cellular changes to abnormality (P<0.05).

Due to the high prevalence of HPV in population studied, earlier diagnosis and genotyping of HPV could be helpful in preventing cervical malignancies.

Intertrocentric femoral fracture is the most common fracture and has the highest mortality rate after surgery. The main treatment for this type of fracture is surgery and the choice of appropriate surgical instrument plays a key role in reducing the incidence of complications. This study amed at comparing clinical outcomes between Dynamic Hip Screw (DHS) and Proximal Femoral Nail (PFN) in surgical treatment of unstable intertrochanteric fractures of the femur.

A cross-sectional study using causal-comparative design was conducted in all patients attending orthopedic clinic in Sari Imam Khomeini Hospital with intermittent femoral fractures who needed surgical treatment between 2012 and 2018. Thirty patients were randomly divided into two groups to be treated either by DHS or PFN implants. The two groups were compared for clinical results, including operation time and and anesthesia time, the need for blood transfusion during and after the surgery, cut out of the device, fracture fusion, and neck and emoral trunk angles. Data analysis was done in SPSS V21.

Findings showed no significant difference between DHS and PFN implantation in terms of fracture fusion (P= 0.234) and cut-out of the device after the surgery (P= 0.157). It was also found that DHS required less time for surgery and anesthesia (P= 0.012). Patients treated with DHS also required significantly less blood transfusion than those in PFN group (P= 0.02).  

In this study, treatment of unstable intertrochanteric fractures using DHS was found to be superior to PFN due to lower length of surgery and anesthesia, and lower need for blood transfusion.

Mucopolysaccharidosis VI is an inherited autosomal recessive disease that causes glycosaminoglycan deposition in different tissues due to arylsulfatase deficiency that can cause various systemic and ocular manifestations. The disease is rarely reported. This paper presents the case of a five-year-old girl with low vision and discusses ocular manifestations of Mucopolysaccharidosis VI. The patient was referred to Kermanshah Imam Khomeini Hospital due to low vision. On examination, she was found with multiple systemic and ocular symptoms. Laboratory results showed arylsulfatase B deficiency. According to the clinical manifestations and laboratory results, she was diagnosed with mucopolysaccharidosis type VI and treated with Naglazyme. Awareness of ocular symptoms in these patients could be of great help in making proper diagnosis and choosing the best treatment that could improve the quality of life in these patients.

Transposition of great arteries can be surgically treated with senning procedure. Atrioventricular block is recognized as a late complication of this surgery. Many patients eventually undergo pacemaker implantation even though transvenous approach might be difficult and complex due to abnormal anatomy. This article describes the case of a 24-year-old patient who was referred to Tehran Heart Center complaining from fatigue, dyspnea, palpitation, and dizziness. At one year of age he had undergone a senning procedure and a few years later a ventricular single lead pacemaker was epicardially implanted for him due to complete heart block. Clinical evaluation revealed A-V dyssynchrony and pacemaker syndrome, so we decided to change the peacemaker to transvenous dual-chamber device. After evaluating the risk of embolization and assessing the venous anatomy, atrial and ventricular leads were successfully implanted. Pacemaker function was normal and no complications were observed in the patient who was free of symptoms during the follow-up period. According to our experience, in such circumstances, if assessment of risk factors indicates that endocardial lead fixation is feasible, it will be the best approach for pacemaker implantation.

Multisystem Inflammatory Syndrome in Children (MIS-C) is recognized as a life threatening complication of Coronavirus disease (COVID-19) in children which can affect major systems such as cardiovascular, respiratory, blood and coagulation, renal, and nervous system. Mild cases of MIS-C can be followed up closely, but, severe illnesses that require hospitalization or pediatric intensive care are also common. Treatment of these patients includes supportive measures to improve the function of vital organs such as the heart and arteries, respiration, and kidneys. Antiviral therapy is recommended in patients with clear involvement of the respiratory system. Treatment with empirical antibiotics and drugs effective in suppressing or modulating the immune system such as steroids in various doses, intravenous immunoglobulins, biologic drugs, anticoagulants, and antiplatelets are recommended. In case of shock or decreased cardiac function, vasopressor drugs are suggested along with supportive measures to maintain tissue perfusions such as albumin and compressed red blood cells. Timely diagnosis and appropriate treatments improve the patientchr('39')s condition and evaluation of long-term complications of this disease should be done.

Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been a major concern since it first emerged. Prevention of Coronavirus 2019 disease (COVID-19) and slowing the epidemic and prevalence of the disease are the main goals of health institutions all over the world. it is very difficult to control the disease and predict its prevalence due to the continuous changes in the form of single nucleotide polymorphism (SNP) and mutations in this virus. In fact, some changes and mutations in Corona 2019 virus directly affect the pathogenicity and its transmission. The most important mutations that occur in the spike or RBD part of the SARS-CoV-2 virus, change the function of the virus, its severity of pathogenesis, and creates new variants. Mutations in these variants change the ability of the virus in binding to human cells, the rate of transmission, and make it easier to escape the immune system which plays a role in the effectiveness or ineffectiveness of vaccines. This study reviews eight major mutations in the spike or RBD region, their presence in different variants of Corona 2019 virus, and their relationship with response rate in infected people. Search keywords included COVID-19, mutation, variant, coronavirus, and respiratory infection in Google Scholar, PubMed, Springer, ScienceDirect, and Scopus databases. The main variations made from SARS-CoV-2 are Alfa (B.1.1.7), Beta (B.1.351), and Delta (B.1.617.2) that cause the infection to spread faster and the adequacy of vaccination on these variations have not been conclusively analyzed at this point.

Ferroptosis is a new type of programmed cell death that plays an important role in various cardiovascular diseases, such as myocardial infarction, reperfusion injury, and heart failure. Cardiomyocyte loss is the most important determinant of morbidity and mortality, so, it is crucial to fully understand the regulatory mechanisms of ferroptosis signaling. In fact, inhibition of cardiac ferroptosis is a promising therapeutic strategy for cardiovascular diseases. However, the biological and pathological contexts in which ferroptosis might operate are poorly defined. Herein we discuss the role of ferroptosis in various cardiovascular diseases, provide an update on current knowledge about the molecular mechanisms that govern ferroptosis, and discuss about the role of ferroptosis inhibitors in control of ferroptosis induced cardiovascular disease in animal models.