مجله دانشگاه علوم پزشکی مازندران
پیاپی 155 (آذر 1396)

Background and Oxidative stress is amongst the factors that change the parameters of sperm and embryo development. This study investigated the protective effects of vitamin E on sperm parameters and In Vitro Fertilization (IVF).
In the present study, male mice were divided into four groups to recieve physiological saline (control group), PHZ, vitamin E 㱶, and vitamin E. Female mice were used for In Vitro Fertilization. Thirty five days after treatments, the male mice were euthanized and their sperm parameters were studied. Stimulating ovule development was done. The animals were euthanized, and then the ova were fertilized. Data analysis was conducted in SPSS applying ANOVA.
Compared to the control group, the mean percentage of sperms with damaged DNA, lack of nuclear maturation, and abnormal morphology increased significantly in PHZ group, which was improved by antioxidants (P Current study showed that vitamin E could improve sperm indicators and embryological development in vitro. Therefore, it is recommended in order to improve the aforementioned parameters.

Background and Brucellosis is a systemic infection caused by gram-negative coccobacilli and facultative intracellular bacteria of the genus Brucella. Interleukin-17 is one of the important cytokines that plays a role in controlling host immune response in patients with brucellosis. The aim of this study was to investigate polymorphism of the genes encoding IL-17 in patients with brucellosis compared to healthy subjects.
This case-control study included 86 patients with brucellosis who were selected based on clinical symptoms, serology, culture and PCR results. The control group composed of 86 healthy people. The polymorphism gene encoding Interleukin-17 was evaluated in both groups by PCR-RELP method.
Current study showed that the frequencies of AA [OR=0.047 (95%CI: 0.01-0.12)] and GG [OR=337.20 (95%CI: 20.49-5541.39] were significant at position -1998 (G/A) in both cases and controls [P-values (AA) and (GG) = 0.001]. But, the frequency of AA genotypes in the control group was greater than the frequency of GG genotype in patients. The odds ratio for catching brucellosis in people who have genotype GG was 41 times higher than those who have genotype AA.
Findings showed that, AA and AG genotypes at -1998 (A/G) position are more important. So, the risk of brucellosis in people with GG genotype at position -1998 was higher than that in people with AA genotype. In other words, people with AA genotype are more protected against brucellosis at this position.

Background and Sexual dysfunction is common among women. It affects all aspects of a women's life. Many of these problems could be treated in early stages via counseling. So, the aim of this study was to determine the effectiveness of group counseling based on Reality Therapy on sexual satisfaction in women.
A clinical trial was conducted in Arak, Iran 2016. The participants included 40 women attending five health centers. They were selected based on inclusion and exclusion criteria and were randomly assigned into either a control group or an experimental group. Experimental group took part in counseling sessions based on Reality Therapy (8 sessions, 90 minutes, twice a week) while the control group received no intervention. Data was collected using personal characteristic form and Larson Sexual Satisfaction Questionnaire (LSSQ). They were completed by the participants before and four weeks after the intervention.
The mean scores for sexual satisfaction in intervention and control groups were 81±13.78 and 79.85±12.3 before the counseling, showing no significant differences between the two groups (P=0.7). But after Reality Therapy, the values significantly changed in intervention group (97.39±13.79 vs. 85.4±20.5) (P Counseling based on Reality Therapy was found effective in improving sexual satisfaction in women.

Background and Evidence shows many kinds of psychological disorders and problems in interpersonal and social communications associated with diabetes. Such problems reduce the quality of life of people involved. The aim of this study was to investigate the prevalence of psychiatric disorders in patients with type II diabetes.
This cross-sectional study was conducted in 202 type II diabetic patients with at least one year experience of the disease attending endocrine clinic in Sari, Iran 2015. Data collection was carried out using a demographic questionnaire, the SCID-I and General Health Questionnaire (GHQ-28). Data was analyzed in SPSSV20.
The mean duration of diabetes was 9.67±6.6 years. Among the patients 25.4% had major depressive disorder, 34% had obsessive-compulsive disorder, and 4.6% were found with generalized anxiety disorder. According to SCID-I, 9.57% had at least one psychiatric disorder and based on GHQ-28, 37% had mental health problems.
High prevalence of mental disorders was found in patients with type II diabetes. These disorders have negative impacts on the control and treatment of diabetes, therefore, psychiatric consultations on a regular basis are necessary to avoid further problems.

Background and Low self-efficacy is a major barrier that plays a significant role in non-adherence to self-care practices in patients with Chronic Heart Failure (CHF) and depression. This study was designed to determine the effectiveness of motivational interviewing on self-efficacy in CHF patients with depressed mood in two hospitals in Zahedan, south east of Iran, 2016.
A randomized clinical trial was carried out in 82 patients suffering from heart failure, who were confined in hospital and whose depression was confirmed by Beck’s questionnaire and a mental status examination. They were randomly divided into intervention and control groups (n= 41 per group). The Self-Efficacy for Managing Chronic Disease was administered. The intervention group received four sessions of self-care behavior education (based on principles of motivational interviewing), and the control group received four routine sessions of self-care behavior education. Eight weeks after the intervention, the level of self-efficacy was evaluated in both groups. Data was analyzed applying paired t-tests, independent t-tests, Chi-square test and analysis of covariance.
The mean score for self-efficacy was significantly higher in intervention group (42.92 ±4.13), compared to that in the control group (37.21±5.16) (P= 0.0001).
Motivational interviewing had a significant positive effect on adherence to self-efficacy in patients with heart failure and depression. Therefore, using motivational interviewing is recommended in these patients.

Background and Deep fissures of occlusal surface in recently erupted first permanent molars are prone to accumulation of bacterial plaque. Sealing these fissures by appropriate flowing materials, as pit and fissure sealants, is a conservative way to prevent caries. The purpose of this study was to compare retention of flowable composite resin by resin modified glass ionomer sealant in six months period.
The occlusal surfaces of the first permanent mandibular molars of 50 children aged 6 to 12 attending pediatric department in dental school affiliated with Qazvin University of Medical Sciences were assessed via Williams probe, intra-oral mirror, and diagnodent. After confirming absence of caries, flowable composite resin were placed on the left first permanent mandibular molars, and resin modified glass ionomer (RMGI) were placed on the opposite side. After 6 months, 46 patients referred for follow up, in whom the retention of sealants was assessed using sharp explorer and intra-oral mirror, and caries were assessed via diagnodent. Data was analyzed in SPSS20 applying Chi- square test.
The retention of flowable composite (91.3%) was significantly more than that of the resin modified glass ionomer (56.5%) (P The flowable composite resin could be used as a fissure sealant agent, due to its greater retention compared to resin modified glass ionomer.

Background and Increase in elderly population of a country requires new policies and plans. Therefore, it is necessary to study the state of aging in the country and different provinces. This research aimed to study the status of population aging based on the recent census data and identifying effective factors in Iran.
Indicators of population aging, including the median age, dependency ratio, growth rate, sex ratio, illiteracy ratio, potential support ratio, parent support ratio, labor force participation, and general fertility rate were calculated for 31 provinces based on the population census information in 2016. Then multiple regression was used to identify the relationship between ageing and the indices aforementioned, in R package.
According to the results, the elderly population in Iran included 51% females and 49% males. General fertility rate and potential support ratio were found to have significant effects on ageing (P Aging and its inevitable socio-economic, health and cultural consequences call for further (special) services for elderly population. Also, using the experience of other countries could be of great benefit.

Background and Urban family physician was implemented as a pilot project in Fars and Mazandaran provinces in Iran since 2012. This study aimed at SWOT analysis of urban family physician from the perspective of beneficiaries.
This qualitative research was conducted through in-depth and semi-structured interviews in 2016. Nine people including faculty members, family physicians, senior managers and health professionals who were fully informed about the family physician project. They were selected via purposive sampling. Verbatim transcription of interview data was done and analyzed using framework method.
The main strengths included health services provision, easy accessibility to health services, classification of services, and decrease in unnecessary costs. The weak points according to SWOT analysis included management and planning, human resources, physical resources, referral system, electronic health records, payment mechanism, health services purchasing organizations, intersectoral coordination, and assessment and control systems. Authorities’ support, legal backing, educated human resources, and capacity of private section along public section were identified as the opportunities of the project. Furthermore, failure in public-private sector cooperation, health market and, society needs were considered as the threats.
This study showed the strengths and weaknesses of family physician plan, and the opportunities and threats it is faced with. Hence, it is necessary to find solutions and perform necessary interventions in order to eliminate the weaknesses and threats and maintain and improve the strengths and opportunities before its implementation throughout the country.

Background and Phenol is amongst the dangerous environmental pollutants with wide applications in today’s life and industry. Nanoparticles have recently received attention for decomposition of these organic compounds. The aim of this study was to evaluate the efficiency of silver doped titanium dioxide stabilized on concrete bed via photocatalytic process Ag-TiO2/UV in removal of phenol from synthetic wastewater.
In this experimental-applied study, the volume of sample was 1000 ml. Initial concentrations were 10, 20, 50, and 100 mg/l and the samples were separately investigated under the effect of UV radiation and Ag-TiO2. The experiment was then performed under both conditions simultaneously. The variables included pH, initial phenol concentration, storage time, and photocatalyst loading. Phenol analysis was carried out by direct light metering with 4-aminoantipyrine reagent at 500 nm wavelength spectrophotometer according to standard method D5530. We studied the pH in three ranges (5, 7, and 10) and photocatalyst in three regions (20, 60, and 80 g/m2).
Based on the results, the highest levels of phenol decomposition were achieved by initial concentrations of 10 and 20 mg/l in optimal pH (3) at 40 and 80 minutes (100%), and initial concentrations of 50 and 100 mg at 180 and 200 minutes retention time in optimal pH (65% and 50%, respectively). The optimal photocatalyst loading rate was 80 g/m2.
This study showed that the Ag-TiO2 nanophotocatalyst stabilized on a concrete bed, is efficient in phenol decomposition in presence of UV light.

Background and Presence of natural organic substances in surface water supplies could be harmful and have adverse effects on drinking water treatment due to many practical and hygiene reasons. This study aimed at investigating the efficiency of catalytic ozonation process in removal and mineralization of humic substances in water resources in north of Iran.
Water treatment plants in Gorgan and Sari were studied (2017). First, the concentration of humic substances was measured in water. Then catalytic ozonation process (COP) of the water samples were performed using semi-continuous cylindrical reactor. The effects of some parameters such as reaction time (0-60 min) and catalyst dosage (0 and 3 g/L) on removal efficiency and mineralization of humic substances were investigated. After determining the kinetics constants of reactions, the removal efficiencies were compared between COP and single ozonation process (SOP).
The concentrations of humic substances in water samples in Sari and Gorgan were 15.22 ± 5.39 and 18.62 ± 6.16 mg/L, respectively. The efficiency of removal of humic acid and its mineralization in the COP process under optimal conditions for Naharkhoran, Sari Salim Bahram, and Alangdare water treatment plants, were 100, 84.21, 88.18%, and 100, 83.4, and 78.03%, respectively. The reaction kinetics were first-order and their rates were 2.6, 2.9, and 3.7 folds more than those of the COP process, respectively
Using magnetic activated carbon catalyst coupled with ozonation process, compared to SOP, is 40% more efficient in removal of humic substances. Also, by reducing the ozonation time and the easy recovery of the catalyst and improving the process efficiency it reduces the costs.

Background and The Caspian Sea is the largest lake in the world. Due to having a long coastal line, population areas, agricultural and industrial activity its have always been exposed to variety of pollutants. Due to variaty effects of pollutant on aquatic life and human, periodic investigation of pollutant in water bodis is wery important.
In this study, oil pollution and heavy metal (nickel and vanadium) contamination of sediment and gamaros samples from Guilan province coasts were investigated. For hydrocarbon analyze, the samples were extracted with a Soxhlet extractor and analyzed with (GC-MS). In order to heavy metals analyzes, samples were digested with HNO3 /HCL (1:3) and analysed with ICP-OES spectrometers.
Total mean concentration of PAHs in sediment and Living tissue was 19.8 ng/g and 35.4 ng/g respectively. Also total mean concentration of TPH in sediment and Living tissue was 11.4 µg/g and 38.4 µg/g respectively. mean concentration of nickel and vanadium in sediment was 16.45 µg/g and 45 µg/g respectively also mean concentration of nickel and vanadium in soft tissue was 2.16 µg/g and 2.06 µg/g respectively.
Ratio values of PAH compounds were calculated to evaluate the possible source of PAH contamination. This ratios suggesting that this reagain have a petrogenic and pyrogenic input of PAHs. Sediment quality guidelines were conducted to assess the toxicity of PAH compounds. The levels of total PAHs at all of stations were below the effects range low. Also, concentrations of nickel and vanadium were below the standards.

Background and Karaj River is the biggest aquatic ecosystem in Alborz province which is exposed to a variety of pharmaceutical pollutants. These pollutants have adverse effects of on surface water, biota and even humans. This research aimed to evaluate the level of contamination caused by widely used antibiotics in Karaj River, effluent, and wastewater treatment plants in 20 stations.
Sample preparation and filtration was done and concentrations of pharmaceutical pollutants were measured using HPLC (mobile phase). Data analysis was performed in SPSS V21.
The mean concentrations of antibiotics in Karaj River were as follow: amoxicillin 2.305, erythromycin, 2.229, gentamicin 2.231, and cephalexin 2.325 µg/l. In treatments plants higher concentrations of these antibiotics were found: amoxicillin 7.240, erythromycin 7.301, gentamicin, 7.390, and cephalexin 6.779 µg/l. In wastewater treatment plants the mean concentrations of amoxicillin, erythromycin, gentamicin, and cephalexin were 5.289, 5.362, 5.344, and 4.608 µg/l, respectively.
According to the significant positive correlation between the concentration of such pollutants in water samples, sewage and wastewater, the main reasons for entering these pollutants are believed to be the pharmaceutical residue discharges in urine and sanitary sewer network, septic tanks and sewage discharge of untreated aquaculture facilities in Karaj River. Inefficient treatment processes in controlling and reducing antibiotics are the main causes of high concentration of these pollutants in the environment that needs urgent control.

Background and Acinetobacter baumannii is an opportunistic pathogen that remains persistent in the environment for a long time. The eradication of this bacteria is difficult, since it has the ability to acquire antibiotic resistance. The aims of this study were to identify the ampC plasmid-mediated genes and antibiotic sensitivity of Acinetobacter baumannii strains.
Sixty strains of Acinetobacter baumannii isolates from wound, urine, blood, and respiratory secretions were used. The presence of ampC plasmid-mediated genes including FOX, MOX, DHA, ACC and CIT were evaluated by Multiplex PCR. Antimicrobial susceptibility testing against 5 antibiotics was performed for all isolates.
Multiplex PCR results showed that 39 samples (65%) had the CIT gene, 36 (60%) had the DHA gene, 12 (20%) had the MOX gene and 8 samples (13.3%) harboured ACC and FOX genes. Based on antibiogram results, the highest rate of resistance was found to cefepime (95%) and the highest rate of sensitivity was to gentamicin (45%).
Current study showed a high percentage of ampC plasmid-mediated genes and also high prevalence of antibiotic resistance in Acinetobacter baumannii.

Background and Nowadays, increasing body mass index (BMI) in adolescents that is caused by different factors is a major health threat in communities. This study aimed to determine the BMI of students and associated factors in 5 Iranian ethnic groups.
This cross-sectional study was conducted in high school students aged 12-14 years, from 5 ethnic groups, including Arab, Kurd, Sistani/Baluchi, Turk, and Turkaman. They were selected through random stratified sampling in winter 2015. Data was collected via a questionnaire containing open and closed questions in three sections: demographic, contextual, and dependent variables. The students were classified into four categories: underweight, normal, overweight, and obese according to their BMI. Data analysis was then conducted in SPSS18.
A total of 2444 students was studied of whom 51.9% were females and 56.9% lived in urban areas. The mean BMI of students was 19.7±3.9 kg/m2 and 24.2% were overweight and obese. The highest and lowest rates of overweight and obesity were found in Arabs and Sistani/Baluchi, respectively. In this study, the relationships between BMI and 25 variables were investigated. We observed significant relationships between BMI and ethnicity, having a family car, maternal diabetes, number of children, type of birth, physiological maturity and how to travel between home and school (P According to this study, the BMI in almost a quarter of the students was higher than the normal range. Some personal and family factors could increase students’ BMI. Therefore, interventions to screen and control the BMI in students are needed.

Background and Expectant fathers are directly associated with the quality of life of their wives during pregnancy. The aim of this study was to determine the effect of an educational program held for husbands on quality of life in pregnant women.
A clinical trial was conducted in expectant fathers whose wives attended Mashhad Shariati Hospital, 2016. Convenient sampling was done and the subjects were selected based on the study’s inclusion criteria. They were assigned into either an experimental group (n=31) or a control group (n=30). The educational program was held in three sessions and the main topics included physical, and psychological problems, and nutritional needs associated with pregnancy. No intervention was done in the control group. Women's quality of life was measured before and then a month after the intervention. Data was analyzed by Variance, mean, t-test, and Fisher test.
The educational program increased the total score for quality of life in intervention group (506.9±44.5 vs. 538.9±27.7, p‹0.001).
Educational program held for expectant fathers could increase the quality of life in pregnant women.

Background and Image quality together with low patient dose is two important goals in radiography procedures. Acquire radiographic images with inadequate quality give rise to uselessly patient dose, improper diagnosis, waste the cost and impose the biological effect to the patients. In this study image quality was evaluated for most common radiographic procedures based on indentified image quality criteria in Sari referral governmental hospitals.
In this cross-sectional study more than 1200 radiographic images were evaluated for adult patients in two referral hospitals in Sari. Image quality were assessed based on identified image criteria in the Commission of European Communities guidelines and Merrill's atlas. Image evaluation were done in two image criteria as anatomical visibility and radiographic indicators.
Mean radiographic images which met all quality criteria on anatomical visibility evaluation in Imam Khomeini and Bu-ali sina hospital were %71.9 ± 9.8. The Highest quality adherence was in image edge sharpness as a important radiographic criteria. Lumbar spine radiography had the best image quality in two hospital than the other radiographs.
This study shown that radiographic images in referral governmental hospital in sari had good quality. Having the deep inspiration of patient in chest radiography and proper field size in skull radiography improves radiographic image quality criteria adherence in two hospitals, considerably.

Burkitt’s lymphoma (BL) is a poorly differentiated B-cell lymphoma. It is rare and in Africa as well as occurs most often in children and young adults. In general, BL includes about 1-2 % of all lymphomas in adults, especially those under 35 years of age, and it can be highly malignant and progressive. Herein, we report a 34-year-old woman with complains of toothache. Followed by drainage of mandibular abscess, soft tissue mass appeared in left mandible that was removed by surgical excision and histopathology report confirmed the diagnosis of BL. CT scan findings revealed involvement of abdominopelvic cavity organs, breast and orbital cavity. This type of tumor is very progressive, therefore, early detection and immediate treatment by accurate imaging could help to determine the extent of tumor.

Background and Contradictory evidences indicate that gestational diabetes mellitus (GDM) increase the risk of spontaneous abortion (SA). Therefore, in a systematic review and meta- analysis we investigated the association between GDM and SA.
Relevant articles published between January 2000 and April 2016 were identified by a systematic search in national and international databases. Eligible studies were included in meta-analysis after quality assessment. We also determined the heterogenic index using Cochran’s test (Q) and I2. Based on the heterogenetic results, a random effect model was performed to combine the results. Stata software was used for data analyses.
A total of 26 studies was included in current meta-analysis in which SA was reported in 2280 pregnant women with GDM. But in 24145 pregnant women without GDM SA occurred in 2386. Significant heterogeneity was observed between the results (P Appropriate control and screening for GDM in pregnant women could reduce the risk of SA.

Ischemia-reperfusion injuries (IRI) are the major causes of liver failure after various types of liver surgeries such as biopsy, transplantation, and tumor surgery. Its pathogenesis is multifactorial and complex that involves ATP depletion, hepatocyte edema, acidosis, oxidative stress, inflammation, and microcirculation defect which can eventually progress to liver cell death, systemic inflammatory response syndrome (SIRS), multiple organ dysfunction syndrome, and even acute graft rejection. There are much evidences that suggest applying anti-inflammatory drugs could be a proper strategy to decrease IRI. Dexamethasone is a highly potent synthetic corticosteroid that its beneficial effects on various tissues in IRI are well documented. It also suppresses inflammation and immune response in different pathologic conditions. Its functional mechanism is different in various types of cells and involves: inactivation of NF-κB and AP-1, inhibition of releasing PLA2 and arachidonic acid, and induction of ERK1/2 and SGK-1. By these processes dexamethasone is able to prevent cytokine overproduction and leukocyte activation, recruitment and infiltration. In this review, we aimed to explain the protective effects of dexamethasone on liver ischemia-reperfusion injuries.

Organophosphorus (OP) compounds are cholinesterase inhibitors widely used as pesticides in agriculture and nerve agents in battlefields. Exposure to these compounds leads to accumulation of acetylcholine at cholinergic synapses and overstimulation of muscarinic and nicotinic receptors by inhibiting the enzyme acetylcholinesterase. Seizure activity is one of the major manifestations of OP poisoning that is produced as a result of hyperstimulation of brain muscarinic receptors and subsequent recruitment of other neurotransmitter systems. Disruption of the excitatory/inhibitory balance can lead to OP-induced seizure activity and subsequent brain damages. Gamma-aminobutyric acid (GABA), the main inhibitory neurotransmitter in mammalian central nervous system, is synthesized from glutamate by glutamic acid decarboxylase and modulates neuronal excitability. After release, GABA binds to two different types of receptors: ionotrpic (GABAA and GABAC) and metabotropic (GABAB) receptors. Drugs that enhance GABAA-mediated inhibition are effective in treatment of OP-induced seizures. There is discrepancy in the literatures regarding changes on brain GABAergic system during OP intoxication. This review discusses the mechanism and toxic effects of OP compounds, brain GABAergic system, and how it changes following exposure to OP compounds.