مجله دانشگاه علوم پزشکی مازندران
پیاپی 158 (اسفند 1396)

Background and Cadmium is a highly toxic industrial and environmental pollutant that is known as an important risk factor for developing diabetes. Oxidative stress is reported to be highly associated with diabetes and its complications. The aim of this study was to evaluate the effects of cadmium on oxidative stress response and secretory function of islets of Langerhans from rat pancreas.
Male Sprague-Dawley rats weighing 260-230 g, were divided into two groups, including a control and an experimental group that received cadmium chloride. After intraperitoneal glucose tolerance test (IPGTT) on day 30, the animals were deeply anesthetized and the pancreas was removed for pancreatic islet isolation. Oxidative stress, islet insulin content and secretion were also evaluated in pancreas.
The findings showed a significant increase in blood glucose concentration and significant decreases in body weight, blood insulin level, insulin content, and secretion of pancreatic islet in response to glucose concentrations in cadmium exposed group compared with those of the control group (P In this study, cadmium led to increase in oxidative stress which can be an important factor in the decreased insulin synthesis and secretion from pancreatic beta cells.

Background and Diazinon (DZN), as an organophosphate insecticide, is used in agriculture and have destructive effects on heart. Zingiber officinale (ginger), as a medicinal plant has antioxidant properties. This study was designed to evaluate the effect of ginger against DZN-induced cardiotoxicity in rats.
In this experimental study, 32 adult female Wistar rats were randomly divided into 4 groups, including control, and experimental groups that received ginger (100 mg/kg/day, gavage), DZN (10 mg/kg/day, IP injection), and ginger plus DZN. Ginger was given one hour before diazinon. All drugs were treated for 30 consecutive days. One day after receiving the last drug, oxidative stress parameters (MDA and GSH), serum biochemical, and histopathological assays of heart have been done. Data were analysed using One-Way ANOVA and Tukey test.
The results revealed that DZN significantly increased oxidative stress (increased MDA and decreased GSH content). Histopathological changes induced in heart tissue, were associated with a significant increase in level of cardiac injury markers (CPK and LDH level) in serum. Ginger significantly reduced oxidative stress, decreased CPK, LDH, and improved histopathological damages.
Ginger with antioxidant activity has an effective role against DZN-induced cardiac injury by reducing oxidative stress.

Background and Allium (Liliaceae) genus has about 600 spp. This investigation was designed to study the impact of extraction methods on total phenolic and flavonoid contents, antioxidant, and antihypoxic properties of A. ampeloprasum in mice.
The aerial parts were extracted by three different methods, i.e. maceration, ultrasonic assisted (UAE) and Soxhlet assisted extraction (SAE). The total phenolic and flavonoid contents were determined. Antioxidative capacity was assessed utilizing four different methods. Antihypoxic activities of maceration extract against hypoxia-induced lethality in haemic, asphytic and circulatory hypoxia models.
Soxhlet assisted extract showed the highest amount of total phenolic contents (89.1±3.3 GAE) and Ultrasonic assisted extract showed the highest amount of total flavonoid contents (36.9±1.7 QE). In DPPH radical scavenging activity, maceration extract had higher activity which was significantly different from that of other extracts (IC50 622.6±12.7). Extraction method did not show any effect on reducing power. All extracts showed the same activity (P>0.05). Extracts did not show any good nitric oxide radical scavenging and iron chelating activities. In haemic and asphytic models, the extract at 250 mg/kg showed statistically significant activities compared with that in the controls. In circulatory model the extract at 500 mg/kg, significantly prolonged the latency for death compared with that in control groups (P According to current study, extraction methods significantly affected antioxidant capacities and total phenolic and flavonoid contents. For A. ampeloprasum, maceration extraction was found to be more efficient. It showed high antihypoxic properties.

Background and Controlling inflammation is a major approach in periodontal treatments, but scaling and root planing are not always effective enough. Curcumin is anti-inflammatory and can adjust inflammatory reactions and its efficacy and immunity is proven. The present research aimed at evaluating the potential of Curcumin BCM-95 in treatment of patients with chronic periodontitis.
In a double blind clinical trial, the clinical parameters including, Gingival Sulcus Bleeding Index (GSBI), Loe and Silness Gingival Index (GI), Probing Pocket Depth (PPD), and Clinical Attachment Level (CAL) were recorded at the beginning of the study, at week 6, and month 4. In case group, patients with moderate chronic periodontitis who had no systemic disease with at least one periodontal pocket with 4-6mm depth in each quadrant and bleeding on probing were chosen. After scaling and root planing, the patients took 2 Curcumin oral capsules per day for 4 weeks. The patients in the control group were given placebos.
The effect of time was found to be significant in PPD, GI, CAL, and GSBI. Moreover, significant differences were seen between PPD average measurements before medication, at first follow up, and second follow-up (P The effect of Biocurcumax TM Curcumin (BCM-95) was significant in treatment of moderate chronic periodontitis in PPD between the two groups which reduced this parameter.

Background and Sore throat and hoarseness are some postoperative complications following endotracheal intubation and inflammation of the pharynx, larynx, and trachea. The aim of this study was to determine the effect of eucalyptus vapor on sore throat and hoarseness after tracheal extubation in patients undergoing coronary artery bypass graft (CABG).
In a clinical trial, 100 patients undergoing CABG were selected using convenience sampling. They were randomly divided into two groups (control and experimental). Demographic and clinical data, and the information on sore throat and hoarseness were recorded in both groups, before the intervention and after tracheal extubation. The patients in experimental group were exposed to eucalyptus vapor for about ten minutes after tracheal extubation. This was performed at 1 and 12 hours after extubation. The severity of sore throat and hoarseness was recorded in the two groups at 0, 1, 6, 12 and 24 hours after extubation.
The severity of hoarseness in case group showed no significant difference at the times of immediate to 24 hours after extubation. But, the severity of sore throat significantly reduced at 6 and 12 hours after extubation (P= 0.02 and P= 0.02, respectively).
The eucalyptus vapor in this study could not significantly decrease the severity of hoarseness, but reduced the sore throat.

Background and Prevalence of depression in patients with acute coronary syndrome (ACS) is reported to be 10-40%. Post-ACS depression is associated with higher mortality and morbidity in patients, therefore, it requires more attention.
In a clinical trial (conducted in Babol University of Medical Sciences, 2015-2016), 47 hospitalized patients with ACS diagnosis were randomly allocated into two groups. Twenty-four patients in intervention group received 20 mg/day citalopram and 23 individuals in the control group were followed without receiving citalopram. Hospital anxiety and depression scale (HADS) was applied at weeks 0, 3, and 8. The participants’ quality of life was evaluated at weeks 0 and 8. Seven patients were excluded from the study since they did not return for follow-up.
A total of 40 patients was studied including 14 (35%) males and 26 (65%) females. Mean ages of patients in in intervention group and controls were 63.1±8.8 and 68.4±7.9 years, respectively. Depression and anxiety levels reduced significantly in intervention group and their quality of life increased in week 8 (P Citalopram could be effective in reducing depression and improving quality of life in acute coronary syndrome.

Background and Breast cancer is the second leading cause of cancer death in women and the most common cancer causing liver metastases. Radiofrequency ablation (RFA) is a new method in treatment of liver metastases. This study was designed to evaluate the efficacy of RFA on liver metastatic breast tumors.
In a randomized clinical trial, 52 patients with liver metastases from breast cancer who had less than 5 lesions In a randomized clinical trial, 52 patients with liver metastases from breast cancer who had less than 5 lesions RFA was found as a safe and efficient method in treatment of liver metastases from breast carcinoma and showed a significant synergistic effect in patients under ingesting chemotherapy drugs.

Background and Today, cognitive-behavioral group therapy is empirically supported in treatment of emotional disorders and in some ​​chronic diseases such as diabetes. The aim of the present research was to study the effect of cognitive-behavioral group therapy on glycosylated hemoglobin (HbA1c), self-efficacy, depression, illness perception, and quality of life in patients with type II diabetes.
In this clinical trial, 43 patients were found eligible, of whom 30 were selected using simple random sampling and were divided into two groups: experimental and control. HbA1c was measured in all participants and they completed the Beck Depression Inventory (BDI), Self-efficacy in diabetic patients (DMSES), Illness Perception Questionnaire (IPQ), and Diabetes D-39. The experimental group attended 10 training sessions based on cognitive-behavioral therapy (Beck approach), for 1.5 hours, twice a week. The scales were completed again, after the intervention and a month later. The HbA1c was also measured again.
The mean age of participants was 46.5±7.21 years. At first, both groups were heterogeneous in dependent variables. Cognitive behavioral group therapy decraesed depression (P=0.049) and increased illness perception (P=0.005) in patients with type II diabetes, but HbA1c, self efficacy, and quality of life did not change significantly.
In this study, cognitive-behavioral group therapy was found to have positive effects on reducing depression and increasing the illness perception in diabetic patients. Hence, it is suggested along with current treatments in type II diabetes.

Background and Rheumatoid arthritis (RA) is an autoimmune disease that increase the risk of coronary artery diseases. Metabolic syndrome (MetS) is considered as a risk factor for developing coronary artery diseases. There are some concerns about the association between RA and MetS, therefore, this study was done to evaluate the prevalence of MetS in male RA patients.
In a cross sectional study, male RA patients (n= 50) were evaluated regarding demographic and clinical features including disease activity score 28 (DAS28), health assessment questionnaire (HAQ), visual analogue scale (VAS), and laboratory parameters and compared with 50 age-matched controls. MetS was diagnosed according to the 2005 National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III) and International Diabetes Federation (IDF) definition. The prevalence of MetS was compared in RA patients and controls. Statistical analysis was performed in SPSS V19, and results were considered significant at P The mean ages of RA patients and controls were 49.04±10.2 and 46.12± 9.4 years, respectively (P= 0.139). MetS according to NCEP and IDF criteria was present in 12 (24%) and 18 (36%) of RA patients vs 16 (32%) and 18 (36%) of controls, respectively that was not significantly different. Controls were more likely to have hyperglycemia and hypercholesterolemia, especially higher levels of low density lipoprotein (P According to the present study, prevalence of MetS was similar in RA patients and controls. MetS components should be routinely investigated in male RA patients to reduce the occurrence of MetS and its complications.

Background and The pace of population aging is fast, so maintenance of mental health in elderly is an important issue. This study aimed to assess mental health in older adults and some relating factors.
In a cross sectional study, 400 old people were selected by multi-stage sampling in Tehran 2014-15. Data was collected using General Health Questionnaire (GHQ-28) and the lifestyle questionnaire. Multiple linear regression model was used to determine the adjusted association between demographics and underlying factors with mental health.
The mean age of participants was 67.7±7.63 years and mean score for their mental health was 21.82±11.37. According to regression model after adjusting other covariates, some variables, including gender, age, education, employment, life satisfaction, motor-physical limitations, and using rehabilitation instruments were the predictors of participants’ mental health (P˂ 0.05).
This study revealed that physical health in elderly has a key role in their mental health. Motor-physical disability is one of the main predictors of mental health among old people. Physical activities and health and also employment situation should be considered in interventions designed to promote mental health in older population.

Background and Cutaneous leishmaniasis is endemic parasitic disease in different regions of the world especially in Iran. Khorasan province is endemic for anthroponootic and zoonotic cutaneous leishmaniasis with unequal outbreak. Identification of species could have important implications for the disease and reservoirs control and finding the epidemiologic map. There is no study on this protozoa disease in Fariman, northeast Iran. The aim of this study was to determine the protozoa genotyping in this area.
A cross-sectional study was done in 50 suspected cases in Fariman 2015-2016. After light microscope checking, scrapings from all smears were done for DNA extraction and species identification was done using kDNA- PCR.
Among 50 suspected cases, 40 patients (80%) were found positive with direct smears and 42 (84%) were identified by PCR. Leishmania tropica was identified in 13 (31%) and 29 (69%) were infected with Leishmania major. Two negative smears were positive with PCR. The disease mainly involved those aged 11-20 years (28.6%) and the most common site of lesions was hands (38.1%) as ulcerative form (58%). From 13 cases of Leishmania tropica 75% and 25% were in urban and rural districts, respectively. Also, from 29 cases of Leishmania major 17.2% and 82.8% were in urban and rural districts, respectively. This difference was statistically significant (P= 0.004).
Fariman is a zoonotic leishmaniasis foci in northeast Iran. Further studies on disease reservoirs and vectors seems necessary to control and reduce the number of people affected.

Background and Head and neck cancers are amongst the most common cancers in the world with increasing incidence rate. The aim of this study was to evaluate the quality of life in patients with head and neck cancers in Babolsar, Iran 2016-2017.
This descriptive cross-sectional study was conducted in 65 patients with head and neck cancers attending Babolsar Shahid Rajaii Hospital. The UW-QOL4 was applied and the quality of life was assessed in three stages; before, during, and after treatment. Data analysis was carried out in SPSS V16.
The study population included 49 males (75.4%) with mean age of 62.44±12.44 years and 16 females (24.6%) with the mean age of 59.31±12.27 years. The age range of subjects was 30 to 91 years. Larynx (70%) and tongue (21.5%) were the two most involved areas. The mean scores for patients’ quality of life before, during, and after treatment were 17.7±0.9, 9.1±3.3, and 15.2±2.6, respectively. According to ANOVA analysis these changes were found to be significant (P Quality of life of patients during treatment was significantly lower than that before treatment which increased after treatment. It is suggested to evaluate quality of life of cancer patients along with their treatment to improve their conditions and provide them with appropriate rehabilitation programs.

Background and When couples understand about their fertility problems their mental image might change or experience problems in sexual activities. This research aimed at investigating the effect of sex education on genital self-image in infertile women.
In this clinical trial, convenient sampling was done and random allocation was conducted according to odd and even days in 108 women in Mashhad Milad Infertility Center, 2016. Fifty four infertile women were randomly placed in experimental groups (n= 5- 8 per group) and 54 women were in control group. Three 90-minute educational sessions were held whithin three weeks. After a month, post-test was taken by both groups. Data was collected using a demographic questiionnare, Depression, Anxiety and Stress Scale (DASS-21), and Female Genital Self-Image Scale (FGSIS). Data analysis was done in SPSS V16 applying Kolmogorov-Smirnov Test, Mann-Whitney, Wilcoxon, covariance analysis, Chi-square, and Fisher test.
The scores for sexual self-image was not significantly different between the intervention and control groups before the intervention (P=0.715). But, a month after sex education, the score showed significant differences between the two groups (P=0.001).
Sex education was found to have positive effects on genital self-image in infertile women, therefore, infertility centers are suggested to use such interventions to improve female genital self-image.

Background and Infertility is one of the most commonly diagnosed disease in women that is associated with physical, psychological, and social problems. A major problem that such women are faced with is on their sexual and reproductive health (SRH). Despite extensive studies on the satisfaction and sexual function of infertile couples, there is no studies that investigates SRH issues. The current study aimed at investigating SRH and its related factors among women.
A cross sectional study was conducted and 400 women attending two infertility centers in Sari, Iran, were recruited using convenience sampling (2016-2017). Inclusion criteria included women > 18 years of age with infertility (primary or secondary) with any cause. The Sexual and Reproductive Health Needs Assessment Questionnaire was administered. The participants recorded their stress scores (0-5). Descriptive statistics were reported and logistic regression was used to evaluate the factors related to SRH.
The SRH was found to be inappropriate in 250 (62.5%) women. According to multivariate regression analysis, inappropriate decision making in self health care (AOR=1.75, 95% CI (1.06-2.9)), high stress level (AOR=1.39, 95%, CI (1.14-1.7)), old age at marriage (AOR=0.94, 95% CI (0.9-0.99)), and secondary infertility (AOR=4.5, 95% CI (2.6-7.9)) were associated with SRH.
Factors such as the person making decision about health care, the level of stress, and age at marriage were found to be the variables which could improve SRH in infertile women by appropriate planning and preventive measures.

Background and Today, due to the reduction of water resources, separation of gray water from domestic wastewater and its reuse has gained more interest. The aim of this study was to apply multi-layer filtration (MLF) for removal of nutrients from gray water.
This laboratory-scale study was carried out in 2.3-19.2 gr. COD / L. d organic loading rates (OLR) over a period of 157 days. In this study, synthetic gray water was used as input to the multi-layer filter. The MLF system included three layers: sand, silica, and granular activated carbon. Furthermore, the scanning electron microscopy (SEM) images were used to determine the biofilm formation on the media surface.
The best removal efficiencies of COD, BOD5, TKN, and TP were 98.87, 99.84, 99.5, and 98% achieved in OLR 19.2, 12.8, (13.2, 4.6) gCOD/l.d, SOR 5.76, 2.88, and 5.77 m/hr, respectively. The study on the effect of loading rate revealed that by increase in OLR, the system efficiency to remove BOD5 and COD increased. Nevertheless, for TKN and TP, the efficiency decreased with increase in OLR. Also, according to SEM images, biofilm had grown well in the media, which can be effective in removing pollutants from gray water.
Using multilayer filtration could be an appropriate option in removing nutrients from gray water in different loadings.

Background and There are several methods for removing oil contaminations from the polluted environments. Bioremediation could be considered as one of the best and most practical methods in the removal of oil contaminations. The aim of this research was to determine the bioremediation efficiency for soils contaminated with diesel by the biological stimulation of bioreactors containing vermicompost and activated sludge.
In an experimental study, the soil samples were collected from an area which was free of any oil pollution and 5 reactors containing one kilogram of soil were contaminated with diesel at the mass concentration of 1%. Two reactors were mixed with vermicompost at 15% and 20% mass concentrations and two reactors were mixed with activated sludge at 5% and 10% mass concentrations. Additionally, one control reactor was used to control the process. The pH of the reactors was between 7.5 and 8 and the C:N:P ratio was 100:5:1. The amount of TPH was measured at seven retention times within three months with two repetitions. The total removal of petroleum hydrocarbons (TPHs) was evaluated by GC-FID device.
The highest removal efficiency of TPH (40.24%) was observed in bioreactors containing vermicompost at a 20% mass concentration. In this reactor, the highest percentage of removal was observed in lighter hydrocarbons (50.49%). In reactors containing activated sludge, the average percentage of TPH removal was 32% which was observed in the reactor containing the 10% concentration of sludge. In this reactor, the highest percentage of removal (44.86%) was also observed in lighter hydrocarbons.
Vermicompost and activated sludge can be used in the bioremediation of soils contaminated with diesel. In current study, the performance of vermicompost was found to be more efficient. Also, the results showed that by increasing the concentration of biological modifiers, the removal rate would increase.

Background and Diabetes causes adverse effects on the activity of reproductive system, including impaired spermatogenesis, decreased sperm count, testosterone serum, seminal fluid volume, and loss of sexual desire. The aim of this study was to evaluate the effect of E.cyparissias extract on tissue changes of prostate and vesicle seminal in diabetic rats.
Thirty male Wistar rats were randomly selected and divided into three groups (n=10), including a control group (healthy animals), a diabetic group and a treatment group. Diabetes was induced by streptozotocin in treatment group and the animals received E.cyparissias extract (500 mg/kg) for 28 days by oral gavage. Then, the samples of prostate and vesicle seminal tissue were taken and prepared for histological study using light microscope.
Morphology findings showed increase in secretion and in diameter of tubules and decrease in interstitial space of prostate and vesicle seminal in treatment group compared with those of the diabetic group. Histomorphometric results indicated significant increases in epithelium height, diameter of the tubules of the prostate and thickness of the muscle layer of seminal vesicles in treatment group compared with those in diabetic group (P˂0.05). The study also revealed that gland weight to body weight in treatment group increased significantly compared with that of the diabetic group (P˂0.05).
According to current findings, oral administration of E.cyparissias extract prevented diabetic induced tissue changes in prostate and seminal vesicle in rats.

Gabapentin was first approved for treatment of epilepsy by FDA, but later it received more attention due to its effects on pain relief, especially neuropathic pain and post-herpetic neuralgia, and in treatment of anxiety and insomnia. The most common side effects of gabapentin include somnolence, ataxia, and fatigue. However, no studies have reported gabapentin induced psychotic disorder. Here, we report a patient on gabapentin with symptoms of delusional disorder.
A 42-year-old married housewife without any history of psychiatric disorder, received gabapentin (100 mg once a day) for treatment of first time insomnia. Psychotic symptoms including persecutory delusion occurred and about 12 hours after the onset of symptoms the patient discontinued gabapentin for 24 hours. Consequently, all symptoms were quickly subsided. The patient's assessment was performed using the Naranjo scale. The patient’s score was 9, thus other possible causes of psychosis were ruled out. According to this report, gabapentin could induce psychotic symptoms in patients who have not even had a history of drug use or specific illnesses.

Background and Violence is one of the main aspects of gender inequality that is a major barrier to achieving the goals of global reproductive health. It is directly associated with women's access to health care and health outcomes. In a systematic review, we aimed to investigate the articles on the relationship between intimate partner violence and women's reproductive health.
Electronic databases including, Scopus, ProQuest, PubMed, and Google Scholar were searched for articles published in English between 2010 and 2017.
After evaluation, 31 articles were selected. The lowest and highest prevalence of violence was associated with physical violence (2.8%) and psychological violence (75.9%), respectively. Moreover, violence was found to be associated with six domains of reproductive health including, not using contraceptive methods, abortion, genital tract diseases, poor pregnancy outcomes, and not using reproductive health services.
Systematic review of studies investigated, showed a strong relationship between domestic violence and major aspects of reproductive health. Therefore, it is necessary to prevent domestic violence in order to promote the health of whole community.

Environmental health inequalities (EHIs) refer to general differences in environmental health conditions. This research aimed at introducing the EHI indicators and providing general recommendations that could improve environmental health and reduce the inequalities observed.This research is the review of WHO reports in various regions. A set of 14 EHI indicators was developed and categorized into three inequality dimensions, including housing-related inequalities, group injury-related inequalities, and environment-related inequalities. The environment-related inequalities include four indicators such as lack of access to green/recreational areas, and noise exposure and second-hand smoke exposure at home or work. The housing-related inequalities include six indicators such as inadequate water supply, lack of a flush toilet, lack of a bath or shower, overcrowding, dampness in home, and inability to keep the home adequately warm. According to literature, EHIs exist in all countries, and most often affect disadvantaged population groups. The magnitude of inequalities and the distribution of inequalities varies between countries and also depend on the socioeconomic or demographic variables. The socioeconomic and demographic inequalities in exposure to environmental hazards exist everywhere and could be associated with factors that may affect the risk of being exposed such as income, education, employment, age, sex, race/ethnicity, and specific locations or settings. In addition to these differences in exposure, environmental health inequalities are also caused by social or demographic differences in vulnerability towards certain risks. Finally, further studies are recommended for initial assessment of EHIs in Iran.