مجله دانشگاه علوم پزشکی مازندران
پیاپی 202 (آبان 1400)

Acetaminophen is a common analgesic and antipyretic medication that cause poisoning and damage liver and kidney in case of overdose. In this study, we investigated the effects of alcoholic extract of Eryngium caucasicum Trautv. against acetaminophen-induced oxidative stress in plasma and kidney tissue in BALB/C mice.

The animals were randomly divided into 8 groups: control (saline), acetaminophen (400 mg/kg body weight) and different doses of extract (200, 400, and 600 mg/kg body weight)+ acetaminophen, and the extract at 200, 400, and 600 mg/kg body weight without acetaminophen administered by gavage for a week. Twenty four hours after last treatment, plasma levels of urea, creatinine, plasma antioxidant capacity, malondialdehyde, and tissue glutathione were measured. The effects of extract in experimental groups and the control group were compared using SPSS software.

Alcoholic extract of Eryngium caucasicum Trautv. in acetaminophen-treated mice significantly decreased plasma urea, creatinine and lipid peroxidation (MDA) levels in kidney tissue and increased antioxidant capacity of plasma and tissue glutathione (P<0.001).

The study showed protective effects of the alcoholic extract of Eryngium caucasicum Trautv. against acetaminophen-induced renal toxicity which could be associated with antioxidant properties and scavenging of free radicals of the extract.

Melissa officinalis (MO) is a medicinal plant and is a rich source of antioxidant and phenolic compounds. The aim of this study was to evaluate the protective effect of Melissa officinalis against ethanol induced sub-chronic testicular toxicity in male Wistar rats.

Ethanol extract of MO was prepared and total phenolic and flavonoid contents were determined. The Animals were divided into seven groups: control (treated with normal saline), ethanol (10 mg/kg,ip), ethanol and MO extract (100, 200, and 400 mg/kg), MO extract alone (400 mg/kg), and ethanol+ Vit C (positive control). After 56 days, the rats were sacrificed and testis and epididymis were harvested. Oxidative stress markers including: level of reactive oxygen species (ROS), malondialdehyde (MDA), protein carbonyl (PC), and glutathione (GSH), and also nitric oxide (NO) as an inflammatory factor were assayed in testis tissue. Moreover, sperm parameters analysis and histopathological evaluation of testis tissue were performed.

Ethanol increased reactive oxygen species, lipid peroxidation, carbonyl protein, and nitric oxide and decreased glutathione in testicular tissue. Pathological lesions, decrease in motility, count and normal morphology of sperm were also observed in ethanol-treated groups. Melissa officinalis inhibited ethanol-induced oxidative stress in testicular tissue and improved sperm abnormalities and pathological lesions.

Melissa officinalis showed protective effect against ethanol-induced testicular toxicity which may be attributed to its antioxidant activity. So, it can be considered as an effective supplement against oxidative stress induced by chronic ethanol exposure in testis tissue.

Osteosarcoma, as the most common bone cancer has not shown considerable response to current chemotherapy drugs. New nanotechnology-based drug delivery systems seems to be promising in cancer treatment. The aim of this study was to design and synthesize a niosomal nano-carrier for drug delivery of berberine to Saos-2 cell line, as a model of osteosarcoma.

Different niosome formulations composed of cholesterol (25%) and different surfactants (75%) were prepared using thin film method. The resulting niosome with optimal properties was pegylated by adding 5% of DSPE-mPEG2000. Finally, the cytotoxicity of free form of berberine and berberine-containing pegylated niosome in normal fibroblast cell line (HFF) and Saos-2 cell line were evaluated by MTT assay.

The niosome made of cholesterol (25%) and Tween 60 (75%) showed the highest drug loading and release rate and was selected as the optimal formulation. Findings showed that the optimized pegylated niosome had high loading efficiency and controlled drug release (79.34% and 66.79%, respectively). Finally, MTT assay showed that the berberine-containing pegylated niosome had more toxicity in Saos-2 cell line than the free form of the drug.

The synthesized niosomal nano-carrier had desirable properties such as high loading efficiency and controlled drug release, which can be used as a favorable drug delivery system with low toxicity and high delivery efficiency in order to increase the effect of the drug while reducing its dose.

Pain and burning are the main complaints after hemorrhoidectomy. Traditional Iranian Medicine and medicinal plants have the potential to be used in many similar cases. The aim of this study was to determine the effect of Arnebia euchroma ointment on pain and burning in patients after hemorrhoidectomy.

A parallel clinical trial was conducted in patients candidate for hemorrhoidectomy in Mashhad Qaem Hospital, Iran. Eligible patients (n=115) were randomly assigned into an experimental group or a control group. The experimental group received 10% Arnebia euchroma ointment, twice a day for a week after the surgery and in control group, Eucerin ointment was used. Pain and burning were measured in recovery and at 4, 12, 24, and 48 hours and 4 and 7 days after the surgery using VAS scale.

There were no significant differences in sex, age, disease and surgery history, and level of education between the two groups (P<0.05). Compared to the control group, the experimental group was found to experience less pain in recovery and at 4, 12, 24 hours, and 7 days after the surgery (P<0.001). Burning was significantly lower in experimental group at 4 and 12 hours after the surgery compared to the control group (P<0.01). But in other times, burning was not significantly different between the two groups (P<0.20).

Arnebia euchroma ointment reduced pain and burning after hemorrhoidectomy and did not cause any complications.

Dexmedetomidine is a new sedative that has analgesic and sympatholytic effects. This study was performed to compare the hemodynamic response of dexmedetomidine and fentanyl after endotracheal intubation in lumbar spine surgery.

In a double-blind clinical trial, 80 patients aged 20-65 years candidates for elective spinal surgery were randomly divided into two groups to receive either dexmedetomidine or fentanyl. In case group, dexmedetomidine (0.5 mcg/kg) and in control group fentanyl (1 mcg/kg in 50 ml of normal saline) were administered 10 minutes before endotracheal intubation. Heart rate and mean arterial pressure were measured at 1, 3, 5, and 10 minutes after intubation. Endotracheal intubation quality and first time of postoperative pain were also measured using Copenhagen score and numerical rating scale, respectively.

Heart rates at 1, 3, 5, and 10 minutes after intubation were 77.60±8.29, 75.73±8.12, 76.44±9.62, and 76.43±7.87 in dexmedetomidine group and 82.7±11.31, 82.08±10.91, 79.93±10.0, and 74.28±14.04 in fentanyl group, respectively (P˂0.001). Mean arterial pressure at 1, 3, 5, and 10 minutes after intubation were 87.45±18.68, 82.25±13.78, 81.78±13.77, and 79.13±14.81 in dexmedetomidine group and 94.95±19.40, 92.23±17.51, 88.28±15.20, and 83.18±13.43 in fentanyl group, respectively (P˂0.001). Quality of intubation was not found to be significantly different between the two groups (P= 0.10). The mean of first time postoperative pain was 9.34±7.11 minutes in fentanyl group and 13.66±10.21 minutes in dexmedomidine group (P= 0.03).

This study showed that hemodynamic changes after endotracheal intubation were less in patients who received dxmedetomidine compared to those that received fentanyl.

Obesity as a risk factor puts patients at risk for postoperative complications. Shoulder pain is one of the early post-laparoscopic cholecystectomy symptoms related to CO2, which remains in the abdomen. Motivational spirometry is a novel technique used in management of shoulder pain after LC. This research aimed to evaluate the effect of motivational spirometry on severity of shoulder pain after LC considering body mass index (BMI).

A randomized clinical trial was performed in 84 patients who were candidate for LC. They were randomly divided into a control group and an intervention group. Demographic characteristics and body mass index were recorded. Patients in intervention group used motivational spirometry (10 deep breaths in sitting or semi-sitting positions) in full consciousness every 2 hr after surgery. In both groups, intensity of shoulder pain was measured at 4, 8, 12, 24, and 48 hours after surgery using Numerical Rating Scale (NRS).

Among the intervention group, 28.9% had a BMI higher than 25. Kruskal-Wallis test showed significant differences in pain intensity between patient in the intervention group with different BMI at 4, 8, 12, and 24 hours after surgery (P<0.05).

In this study, motivational spirometry reduced intensity of shoulder pain in patients following LC, however, some patients with high BMI had more sever and long-lasting pain, because obesity impede proper deep and effective inhalation and exhalation in these patients.

Patient education is an important part of treatment process. Educational models such as Health Belief Model (HBM) emphasize on people's motivation. The aim of this study was to investigate the effect of this educational method on self-care performance and metabolic indicators in patients with type 2 diabetes.

In this clinical trial, type 2 diabetic patients were randomly assigned into an intervention group (n=40) and a control group (n=40) (routine care). In intervention group, diabetes knowledge and health beliefs about diabetes, lifestyle, and self-care were taught through lectures and question/answer forum based on health belief model for 90-minute in four sessions. In all samples, fasting blood sugar, HBA1C, lipoproteins, and blood pressure were measured before and four months after the intervention. Also, health belief model constructs and self-care behavior scale were completed. Data were analyzed in SPSS V23 using Analysis of Covariance (ANCOVA).

Compared to the control group, in intervention group, the scores for knowledge (P=0.01), performance (P= 0.01), and self-efficacy (P= 0.04) increased significantly and the score for perceived barriers decreased significantly (P= 0.02). Changes in FBS, LDL, and blood pressure were similar between the two groups, but a significant difference was seen in changes in HbA1C (P= 0.04).

Education based on health belief model seems to be effective in promoting self-care behaviors and control of metabolic complications in diabetic patients, so the model is suggested to be applied also in larger populations and long term studies in other patients such as those with hypertension and cardiovascular disease.

Arthroscopic diagnosis is an invasive and expensive procedure used in diagnosis of meniscus rupture. The aim of this study was to compare findings of magnetic resonance imaging (MRI) and arthroscopy in internal derangements of the knee.

In a descriptive-analytical study using diagnostic approach, a total of 59 patients candidate for arthroscopy in Mazandaran medical centers (2019-2020) were included and the sensitivity and specificity of MRI were investigated and compared with arthroscopy findings as the gold standard. SPSS V22 was applied for data analysis. 

In this study, 59 patients aged 18-60 years (33.2 ± 8.2 years) were studied in three medical centers. The participants included 84.7% males and 15.3% females. The sensitivity, specificity, and accuracy of MRI in reference to arthroscopy for anterior cruciate ligament rupture were 97.7%, 93.7%, and 96.7%, respectively and 93.2%, 87.2%, and 88%, respectively for internal meniscus rupture, and 44.4%, 79.1%, and 71.2%, respectively for rupture of external meniscus.

MRI is a very effective and reliable method in diagnosis of anterior cruciate ligament injuries that could be a suitable alternative to arthroscopy. However, it has moderate accuracy and sensitivity in diagnosis of posterior horn of lateral meniscus injuries.

Gastric adenocarcinoma is the fifth most common cancer and the fourth leading cause of cancer death in both men and women. Transthyretin (TTR) is a useful marker for cancer diagnosis and prediction in patients undergoing surgery. The diagnostic value of this biomarker in gastric cancer has not yet been determined conclusively. This investigation aimed at studying the diagnostic role of serum TTR in patients with gastric cancer.

This case-control study, was performed in 40 patients whose gastric cancer was confirmed pathologically and 42 healthy individuals without family history of gastrointestinal and liver cancers. The sandwich prepared ELISA kit was used to determine the concentration of transthyretin protein produced in serum.

The mean age of patients with gastric cancer was 63 ± 13 years and the mean age of the control group was 64 ± 16 years (P= 0.681). The mean serum concentrations of transthyretin in patients and healthy people were 138.45 ± 49.64 pg/mL and 113.53 ± 60.12 pg/mL, respectively. Findings showed a significant difference in serum transthyretin levels between the two groups (P= 0.045). Therefore, TTR could be used as a diagnostic marker.

In this study, serum levels of transthyretin were significantly higher in patients with gastric cancer than healthy individuals.

Fatigue and dyspnea are common asthma symptoms and using non-phamacological methods are preferred to reduce the symptoms in elderly. Guided imagery is a mind-body intervention and is effective in reducing physiological problems. The present study was conducted to determine the effect of guided imagery on fatigue and asthma control in older adults.

In a randomized clinical trial, 90 elderly with asthma attending Sari Imam Khomini Hospital and Qaemshahr Razi Hospital (2020) were allocated into either an intervention group or a control group (n= 45 per group) using randomized blocking. Patients in intervention group listened to a 12-minute audio file of guided imagery for six weeks, twice a day (except weekends). Data were collected using demographic questionnaire, asthma control questionnaire, and fatigue severity scale and then analyzed in SPSS V22 applying Mann-Whitney U test, Wilcoxon test, and Chi-square test.

A total of 80 elderly were analyzed. After six months, the score for fatigue in intervention group reduced to 33.10±6.74 from 38.11±6.65 before the study (P<0.001), but no significant difference was seen in control group before and after the study (37.96±6.60 and 38.17±6.42, respectively, P=0.059). After six months, asthma control score in intervention group increased to 17.90±4.78 from 14.22±3.40 before the intervention (P<0.001). But the score change in control group was not found to be significant (17.77±4.66 before the study and 17.83±4.50 after the study, P=0.226).

Guided imagery as a non-pharmacological method seems to improve asthma control and decreases fatigue in elderly with asthma. Implementing such measures is recommended to health providers.

Camel breeding is common in East of Iran due to its semi-arid climate and desert conditions. It transmits some diseases to other ruminants and humans due to carrying common blood parasites between humans and animals. This work aimed at studying the presence of Trypanosoma and Piroplasmida (Babesia and Theileria) species in camels in South Khorasan province using parasitological and molecular methods.

In this study, blood samples were taken from 200 camels in South Khorasan that were randomly selected in 2020. Then, thick and thin smear were prepared from the samples and stained with Giemsa staining technique and examined under a light microscope. For molecular detection of Trypanosoma, Theileria and Babesia, specific primers of each genus were used.

Microscopic examination showed that out of 200 blood samples, 8 samples (4%) were infected with Trypanosoma and no samples were infected with Theileria and Babesia. According to molecular experiments, six samples (3%) had DNA of Trypanosoma evansi and five samples (2.5%) were found with Trypanosoma brucei DNA. But the DNA of Theileria and Babesia were not observed. Phylogenetic analysis showed that the sample isolated in the present study had a high genetic affinity with genotype A of Trypanosoma evansi.

To the best of our knowledge, this was the first study to investigate the prevalence of Surra in South Khorasan province. The presence of Trypanosoma in the blood of camels in this region signifies the need for a careful monitoring system and evaluation studies as a prerequisite for controlling blood parasitic diseases in camels in South Khorasan.

In orthodontic brackets, unlike restorative materials or porcelain, the shear bond strength of the adhesives used is important because the oblique forces from food or objects or the tension of the adhesive food affect the brackets. This study aimed at measuring and comparing shear bond strength and adhesive remnant index of light cure composite, no mix (self-cure) composite, and no bond composite (GC Orthoconnect).

A total of 27 non-carious and sound human premolar teeth were used. The samples were divided into three groups, including light cure composite, self-cure composite, and no bond composite (GC Orthoconnect). After bonding and thermocycling process, the metal brackets (American Orthodontics) were then debonded using universal testing machine. Adhesive remnant index (ARI) score was assessed.

The highest and lowest SBS mean values were seen in self-cure group (18.0402±5.71665) and light cure group (7.7890±3.98995), respectively. There were significant differences in SBS values between all groups except between the no bond group and the self-cure group (P= 0.18, P>0.05). The highest ARI scores were 0 in the self-cure group and 3 in the no bond group and the light cure group.

The no bond composite provided acceptable overall shear bond strength and compared to light cure composite showed higher shear bond strength and lower bond failure.

Secondary caries is one of the main causes for replacement of dental restorations. Glass ionomer cement (GIC) has cariostatic properties and antibacterial effect due to the ability to release fluoride. The aim of this study was to compare the antibacterial activity and fluoride release between three different formulations of GIC.

This experimental study was conducted in Ardabil Dental School, Iran 2020. We evaluated fluoride release (n=15) and antibacterial activity (n=24) of three GICs including Fuji IX GP Extra, Fuji II LC, and Equia Forte against Streptococcus mutans and Lactobacillus acidophilus. Microtubes containing each bacterium and no glass ionomer were considered as positive controls. Antibacterial activity was studied using well diffusion test and time-kill curve was measured. The amount of released fluoride was measured at days 1, 2, 3, 4, 7, 14, and 21 by specific fluoride electrode. Data were analyzed applying ANOVA, post hoc Sidak, and Tukey test.

Fuji IX GP Extra and Equia Forte showed significantly higher and lower antibacterial activity against both strains, respectively (P<0.001). The least fluoride release was associated with Equia Forte (P<0.001), but Fuji IX GP Extra and Fuji II LC did not show any significant difference (P>0.05).

Fuji IX GP Extra had the greatest growth-inhibitory effect on Streptococcus mutans and Lactobacillus acidophilus due to the highest fluoride release.

Atopic dermatitis (AD) is a common and drug-resistant inflammatory skin disease and its prevalence is 9-20% throughout the world. Vitamin D has been recently suggested as a potential option for AD treatment. The goal of this study was to assess Vitamin D3 levels in infants and children with AD and investigating the relationship between Vit D3 levels and AD severity.

A cross-sectional analytical study was carried out in children diagnosed with AD attending the Allergy and Immunology Clinics in Urmia Shahid Motahari Hospital, West Azarbaijan province, Iran. One-way ANOVA was applied to understand the relationship between disease severity and Vit D3 levels. All data analyses were performed in SPSS V16.

In this research, 46 people, including 29 males (63%) and 17 females (37%) were studied. Mean age of patients was 36.36±4.85 months, mean SCORAD (SCORing Atopic Dermatitis) was 45.94±2.84, and mean vitamin D3 levels were 30.70±2.35 ng/mL. Findings showed significant relationship between decrease in SCORAD and increase in vitamin D3 levels (P=0.046).

The current study, consistent with other studies, showed significant relationship between vitamin D3 levels and AD severity.

Ventilator-induced pneumonia is the most common nosocomial infection in intensive care unit patients. The aim of this study was to compare the common ventilator-associated pneumonia in two groups of children and adults in the intensive care unit of Bahonar Hospital in Kerman in 2019.

The records of 146 patients in both pediatric and adult groups in the intensive care unit with ventilator-associated pneumonia were reviewed cross-sectional. Broncho alveolar lavage samples were taken from the patients and examined for the presence of operating bacteria.

The mean age of patients in children and adults was 11.2±5.5 and 53.8±19.3 years, respectively. The mean duration of ventilation in children and adults was 12.2±8.14 and 17.7±15.3 days, respectively. The mean time interval between ventilation and infection was not statistically significant between the two groups (P = 0.1). The mean length of hospital stay was 27.5±20.5 in the pediatric group and 40.7±23.4 days in the adult group (p=0.00). Acinetobacter (40%) was the most common disease in both age groups. Most patients in both children and adults were recovered and discharged.

According to similar crimes in the age group, in case of clinical and laboratory symptoms of VAP, a similar antibiotic treatment can be selected.

Cytomegalovirus (CMV) infection is a serious problem during pregnancy as it threatens the mothers’ health and also leads to fetal abnormalities and/or deaths. There is paucity of information about the incidence of CMV in pregnant mothers in Sari, Iran. Therefore, this study was carried out to investigate the frequency of CMV during pregnancy and the relationship between that and related epidemic parameters in Sari.

A descriptive-observational study was conducted in pregnant women participating in Sari Birth Cohort (SBC) Center during 2018-2020. A total of 1092 samples were investigated for serological markers of CMV using ELISA. Data analysis was performed applying Chi-square and logistic regression.

Prevalence of positive CMV-IgG and IgM in samples studied were 91.8% and 0.2%, respectively. Educational level (P= 0.03) and pregnancy stage (P= 0.02) were found to be significantly different between mothers with positive IgG and negative IgG.

In current study, pregnant women in third trimester whose educational level was bachelor’s degree or less had CMV infection. Despite prenatal screening, cytomegalovirus can be reactivated during pregnancy, therefore, follow-up of the fetus for fetopathy is recommended.

This study aimed at examining the effect of cusp coverage on fracture resistance of endodontically treated maxillary premolars restored with direct composite.

In this in vitro study, 84 sound extracted maxillary premolars were divided into three groups (n=28 per group). In all groups, root canal treatment was performed and access cavity preparation was designed as MO while preserving distal marginal ridge. In group I, buccal and palatal cusps were reduced and in group II, palatal cusps were reduced. No cusp reduction was done in group III. All teeth were restored with resin composite and underwent compressive load applied simultaneously to both cusps with an instant speed of 0.5 mm/min using an Instron machine. Data were analysed in SPSS V16.

The mean fracture resistances in groups I, II, and III were 3.4±1.06, 2.7±1, and 2.56±0.84 MPa, respectively. The mean effect of cusp coverage on resistance was significantly higher in group I compared to groups II and III (P≤0.05). Fractures in the area of CEJ or a more coronal position (favourable) in groups I, II, and III were seen in 23 (82.1%), 25 (89.3%), and 27(96.4%) cases, respectively, indicating no significant differences between the three groups.

In direct composite restoration of endodontically treated premolars when a proximal surface is involved, higher fracture strength is achieved by MO/DO cavity preparation and both buccal and palatal cups reduction while preserving marginal ridge.

Eosinophilic fasciitis presents as painful symmetrical stiffness and limb sclerosis with deep fascia inflammation. Unilateral conflict has been rarely reported. In this paper, a young man with unilateral thigh and leg involvement is presented who developed symptoms following strenuous exercise. Clinical, laboratory, imaging, and pathology findings are discussed. Treatment with prednisolone and methotrexate was started.

Increased urbanization in developing countries has led to increase in non-communicable diseases such as cardiovascular disease. Primary prevention of atherosclerotic vascular disease could be achieved by promoting healthy lifestyle throughout life. Team care approach is an effective strategy to prevent cardiovascular disease. Physicians should consider social factors affecting health to make appropriate treatment decisions. The present study will provide a brief overview of the latest clinical guidelines for treatment of lipid disorders in primary prevention of cardiovascular disease in adults.

In this narrative review, a comprehensive search of electronic databases (pubmed, scopus, google scholar, uptodate, and Embace) was done using the following keywords: primary prevention, cardiovascular disease, LDL cholesterol, and guideline. The goal of this study was to review the latest guidelines for lipid treatment in prevention of cardiovascular disease from 2015 onwards. Six articles were obtained in this field.

To prevent cardiovascular disease in diabetic patients aged 40-75 years, a moderate dose of statin is recommended. In non-diabetic patients, high-dose statin should be given for LDL levels ≥ 190 mg/dL. Also, 10-year risk of atherosclerotic heart disease should be calculated in non-diabetic patients aged 40-75 years old with LDL levels of 70-190 mg/dL to make treatment decisions.

According to access to the latest clinical guidelines, depending on patient's condition and type of disorder, therapeutic interventions in lipid disorders are recommended for primary prevention of cardiovascular disease.

Environmental factors can play a role in incidence, infection, and mortality rates of Coronavirus disease (COVID-19). In this study, we performed a systematic review of environmental factors affecting the incidence, infection, and mortality rates of COVID-19.

In this review, articles, case studies, and official reports were searched in electronic databases, including PubMed, Scopus, Web of Science, Google Scholar, Magiran, and Scientific Information Database (SID)  using the following keywords: COVID-19, Environmental factors, Air pollution, Temperature and humidity, Water and wastewater, and Coronavirus. Studies on the relationship between environmental factors affecting infection and mortality rates of COVID-19 published until July 2021 were selected. Qualitative evaluation of articles was performed using the STROBE checklist.

Out of 62 articles found 30 were reviewed. Air pollution, temperature, humidity, water, wastewater, and waste could play a role in incidence, infection, and mortality rates of COVID-19. Environmental control was found to be effective in preventing the spread of infection and reducing the mortality rate of COVID-19. Improving environmental performance could be of great benefit in preventing the spread of many diseases, particularly the COVID-19 pandemic.  

Ensuring global environmental performance is essential to protect all countries against COVID-19 and other public health hazards. Meanwhile, more investment in research and development is needed.