مجله دانشگاه علوم پزشکی مازندران
پیاپی 165 (مهر 1397)

Background and

Hydrogels are used as carriers to control drug release. Ostrich oil has fatty acids which plays an important role in growth, division, and health of cells and cause wound healing and have anti-inflammatory effects.

In this experimental study, pH sensitive hydrogel was produced by chitosan deviation and open ring Poly-vinyl pyrrolidon (OR-PVP). The physicochemical characteristics of ostrich oil hydrogel was studied and its analgesic effect on mice was investigated by hot plate and formalin test.

Compared with other formulations, formulations containing chitosan with high molecular weight showed better results. The ratio of OR-PVP to high molecular chitosan was 0.4 for the best formulation. All formulations with 30% ostrich oil were found to have good analgesic effects.

This study showed that ostrich oil hydrogel could reduce inflammation and
central pain

Background and Treatment of leishmaniasis is getting complicated due to multiple side effects and drug resistance to first-line drugs. Agrostemma githago is a plant with anti-cancer and cytocidal effects, so, this study was conducted to evaluate the anti leishmanial effect of its extract on Leishmania major promastigotes by MTT assay and cell count. A total of 2.5×106 Leishmania major promastigotes in their stationary phase were plated to each well of the 96 well culture plates. Cells were then incubated with increasing concentrations of Agrostemma githago extract (0.05 – 2.4 mg/ml) for 48 hours at 25°C. Glucantim was used as standard control. Then, the supernatants were discarded and 50 µl of MTT were added for 3 hours. After centrifuge, the supernatants were replaced by 100 µl of DMSO. The plate was read by ELISA reader at 570 nm. Trypan blue staining was also performed to evaluate the effect of Agrostemma githago extract on Leishmania major promastigotes. MTT assay showed that increasing concentrations of Agrostemma extract could significantly reduce cell viability of Leishmania major promastigots in a dose dependent manner (p<0.05). IC50 of the Agrostemma and Glucantime were 0.365 and 71.01 mg/ml, respectively. Aqueous extract of Agrostemma githago was found to have stronger inhibitory effect than Glucantim on Leishmania major promastigots

Background and Diabetes mellitus affects male reproductive functions at multiple levels such as spermatogenesis, steroidogenesis, and sexual behaviors. The pleotropic protective roles of crocin in different pathological states have been reported, so, this study aimed at examining the protective effects of crocin on spermatogenesis in experimentally-induced diabetes in rats. In an experimental study, 18 male Wistar rats were randomly divided into three groups; normal, diabetic, and crocin-treated diabetic groups. Diabetes was induced using i.v. injection of streptozotocin (40 mg/kg) and treatment group received i.p. injection of crocin (20 mg/kg/day) for 60 days. At the end of the test, we studied blood glucose level, sperm count, and testis weight, and histopathological assessment was also performed. Induction of diabetes enhanced blood glucose levels in diabetic group (229±11mg/dL) whereas crocin significantly decreased blood glucose levels of treated diabetic group (118±4mg/dL) compared with the diabetic group (P=0.001). Sperm number decreased considerably in diabetic group (19.4±24 million/mL vs. 4.4±10 million/mL) but crocin significantly increased that (10.3±14 million/mL), (P=0.037). Diabetes also developed histopathological changes in seminiferous tubules and led to reduction of testis weight in diabetic rats, whereas crocin diminished these damages. Our findings revealed that crocin could protect male reproductive organ against diabetes and improve spermatogenesis in experimentally-induced diabetes in rat.

Background and One of the main issues in cancer treatment is to reduce the side effects of drugs on healthy tissues. The aim of this study was to investigate the preventative effects of continuous aerobic exercise on apoptosis ratio and liver fibrosis induced by doxorubicin in aging rats. In this experimental research, 42 adult Wistar rats were randomly divided into 6 groups (n= 7), including the Young, Aged, Aged+ Saline, Aged+ Dox, Aged+ Exercise+ Saline, and Aged+ Exercise+ Dox. The training groups practiced on treadmill while considering the principle of overload (five sessions per week/ six weeks). On the last 15 days of exercise, doxorubicin or saline solution were injected (1 mg/kg/daily). Then, 48 hours after completing the trainings, liver tissue sampling was performed to evaluate the fibrosis and expression of Bax and Bcl-2 proteins. Data analysis was done using One-way ANOVA at a significant level of P≤0.05. Doxorubicin caused a significant increase in liver fibrosis, expression of Bax protein and Bax/Bcl-2 ratio, and a significant reduction in expression of Bcl-2 protein (p≤0.05). On the other hand, aerobic training significantly reduced the expression of Bax protein, Bax/Bcl-2 ratio and hepatic fibrosis, and significantly increased the expression of Bcl-2 protein (p≤0.05). Continuous aerobic exercises, reduce the Bax/Bcl-2 ratio which is an indicator of increase in survival rate and also reduce liver fibrosis against doxorubicin

Background and Endothelin axis (endothelin or ET) including endothelin A receptor (ETA) play a major role as the regulator of vessels tone and tissue differentiation and development. There are evidences of the importance of endothelin axis in carcinogenesis. No data exists about comparison of ETA expression between dysplasia and oral squamous cell carcinoma (OSCC). So, the aim of this study was to compare immunohistochemical expression of ETA between these two groups. In this cross-sectional study, the paraffin-embedded tissue blocks of 20 cases of dysplastic oral mucosa and 21 cases of OSCCs were investigated. Three micron sections were prepared from tissue blocks and stained with ETA antibody using immunohistochemistry. Percentage of stained cells and staining intensity were compared between the groups applying Mann-Whitney and Chi-Square tests. In dysplasia group, 11 cases stained for ETA while in OSCC group all cases stained. Comparison of percentage of stained cells and their semi quantitative classification showed significant differences between the two groups (P=0.02 and P=0.005, respectively) such that ETA expression was higher in OSCC than dysplasia. Staining intensity for ETA was significantly higher in OSCC group (P=0.006). There were significant differences between ETA expression in mild and moderate dysplasia with carcinoma. Our results support the role of ETA receptor in progression of dysplasia toward OSCC

Background and

The aim of this study was to determine the genetic variability of CYP1A1 m1 and m2 polymorphisms in cancer patients compared with healthy population in the west of Mazandaran province, Iran.

A case-control study was carried out in 120 non-relative healthy volunteers (60 males and 60 females) and 84 non-relative patients (39 males and 46 females) with diagnosis of cancer, attending the Hematology/Oncology ward in Ramsar Imam Sajjad Hospital between July 2016 and December 2017. Peripheral blood samples (3ml) were taken from the participants and stored at -20°C. The PCR-RFLP method was used to determine the distribution of CYP1A1 gene polymorphisms.

Among the two gene variants m1 and m2, individuals with AG and GG genotypes of CYP1A1 m2 polymorphism were found to have a significantly higher and increased risk for cancer (OR=3.94, 95%CI=2.05-7.57, P= 0.00, OR=9.46 , 95%CI=1.92-46.49, P= 0.00, respectively) and the TC genotype of CYP1A1 m1 polymorphism also had a significantly higher and increased risk for cancer (OR= 2.6 , 95% CI = 1.4-4.6, P=0.00). The ‘G’ allele was detected to have a strong association with cancer (P<0.001). The ‘C’ allele also showed strong association with the incidence of cancer (P<0.001). Thus, both CYP1A1 m1 and m2 polymorphisms showed an increased risk for cancer.

Our study suggested that the presence of ‘C’ allele of m1 polymorphism and ‘G’ allele of m2 polymorphism as the leading alleles that increase cancer susceptibility in the studied population

Background and Osteoarthritis is the most common type of arthritis. It is the main cause of chronic musculoskeletal pain and disability in elderly population. The aim of this research was to compare the effects of low-level laser therapy (LLLT) and high-intensity laser therapy (HILT) on pain relief and reducing disability in patients with knee osteoarthritis. A total of 45 female patients participated in this randomized controlled study.The patients were randomly divided into three groups of low level laser, high power laser, and placebo laser. All patients, received standard treatment. Pain at rest and knee function were assessed by visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), respectively before, immediately, and six weeks after the intervention. Low-power laser and high-power laser had immediate and long-lasting effect on reducing pain and disability (p<0.001). The immediate and lasting effect of these two interventions between the two groups were not significantly different (p>0.05). High power laser was found to have similar effects to low power laser. LLLT is believed to be more appropriate since it is more economical for both therapist and patient.

(Clinical Trials Registry Number: IRCT201502224549N8

Background and Gestational diabetes mellitus (GDM) is the most common medical condition that causes anxiety and stress in expectant mothers. Improving self-efficacy in order to change lifestyle is of great benefit in management of this condition. This research aimed at studying the effect of cognitive behavioral therapy (CBT) on self-efficacy of women with GDM. A clinical trial was conducted in 60 women with gestational diabetes (control n=30 and intervention n= 30) attending diabetes clinic in Sanandaj, Iran using convenience sampling. Both groups received routine care but the intervention group were divided into three subgroups (n=10 per group) and also received CBT in seven sessions (1.5-hour per session). Diabetic Self-Efficacy scale questionnaire was administered at three times; before, immediately after, and one month after the intervention. Data analysis was done in SPSS V19. The mean age of participants was 30.25 ± 5.0 years and the mean gestational age was 26.8 ± 3.0 weeks. Before the intervention, there was no significant difference between the two groups in the scores for self-efficacy (P=0.50), but CBT was found to improve self-efficacy (P<0.001). CBT in pregnant women with GDM improved self-efficacy. ‎These women are needed to change their lifestyle, therefore, CBT should be offered in health centers and diabetes clinics to prevent diabetes type II in women with GDM.

(Clinical Trials Registry Number: IRCT2017011631977N1

Background and Satisfaction of caregivers of hospitalized patients is one of the pillars of good quality in patient care. Providing appropriate trainings on this issue could lead to improvements in patient recovery. The present study was conducted to investigate the effects of a training program on satisfaction of caregivers of patients who had Coronary Artery Bypass Grafting. An interventional study was done in 69 caregivers of hospitalized patients in intensive care unit in Sari Fatemeh Zahra Hospital. The samples were randomly allocated into intervention and control groups. In the intervention group, the caregivers of the hospitalized patients alongside routine information received training starting one day before their patient’s surgery until 24 hr before discharge. The Family Satisfaction in the Intensive Care Unit (FSICU) was administered to measure the satisfaction of caregivers in both groups, 24 hr before discharge. Data were analyzed using Mann-Whitney, Independent t-test, and Chi-square. Compared to the control group, a significant difference was found between the mean score for satisfaction in intervention group after the training program (58.3±11.56 vs. 81.28±6.08), (P<0.001). Caregivers reported highest level of satisfaction with medical personnel performance and the lowest with making decisions about patients. According to the findings, nurses can increase caregivers’ satisfaction from nursing care by providing them with training programs and improve patient care after heart surgery

Background and Women's satisfaction with childbirth may influence their transition to motherhood. Training interventions during pregnancy may improve the ability of expectant mothers to cope with stress, promote the maternal role competence, and increase mothers’ satisfaction. This study aimed at investigating the effect of prenatal psychological trainings on satisfaction with childbirth and maternal role competence in primiparous women. This clinical trial was conducted in 122 primigravid women at 14-28 gestational age attending the Healthcare Centers in Mashhad, Iran 2015-2016. The subjects were divided into two groups of intervention and control using drawing. The intervention group received psychological trainings in three sessions. Mackey Childbirth Satisfaction Rating Scale, The Parenting Sense of Competence Scale, and Edinburgh Postnatal Depression Scale were administered. Data were analyzed applying descriptive and analytical statistics. Satisfaction with childbirth experiences was significantly higher in the intervention group compared to that in the control group (23.3% and 12.9%, respectively, P= 0.046). The mean scores for maternal role competence in intervention group and controls were the values61 (10) and 54/5 (12), respectively, indicating significant differences between the two groups (P= 0.003). According to current findings, prenatal psychological trainings increased mothers’ satisfaction with childbirth and enhanced maternal role competence.

(Clinical Trials Registry Number: IRCT2017071135008N1)

Background and

Metabolic syndrome includes a series of risk factors for cardiovascular diseases. The aim of this study was to identify the changes in various indicators of this syndrome during hospitalization in a psychiatric department. Identifying these changes could help in reducing the risk of this syndrome.

A cross-sectional study was conducted in 152 patients with psychiatric disorders who were admitted in Sari Zare Hospital, winter 2016. Fasting blood glucose (FBS), HDL-cholesterol, triglyceride (TG), weight, waist circumference, and blood pressure were recorded at the time of hospital admission and discharge.

Compared to the time of hospital admission, significant changes were seen in waist circumference (p=0.000) and TG (p=0.010) among schizophrenic patients at the time of hospital discharge. In patients with bipolar disorder, significant changes were found in waist circumference, TG, and also HDL at the time of hospital discharge (p= 0.017, 0.004, 0.045). Moreover, we found significant changes in FBS and waist circumference in patients with schizoaffective disorder (p=0.013 and p=0.018, respectively). In patients with substance use, no significant changes were seen in any of the indicators when being discharged from hospital. But patients with brief psychotic disorder showed significant changes only in waist circumference (p=0.005).

Changes in the indicators of metabolic syndrome are much more common than the prevalence of metabolic syndrome. Indicators that are more likely to change during hospitalization and could be used in screening for prevention of metabolic syndrome include waist circumference and TG levels

Background and

Despite appropriate prevention and therapeutic activities in recent years, Pulmonary Tuberculosis (TB) is still one of the top ten causes of mortality in the world. The purpose of this study was to analyze the distribution of pulmonary tuberculosis in cities of Golestan province, Iran and identifying the major determinants of this disease.

from 8374 TB cases was recorded in TB Registry Program in Golestan province between 2007 and 2016 we analyzed the information of 5648 new cases. Data was analyzed in SPSS 24 and Stata 13. Mean ± SD and frequency table were applied for quantitative and qualitative variables, respectively.

The standardized incidence rate of TB in 100,000 population in Golestan province was 41.29 and in males and females it was 41.40 and 41.22, respectively, indicating no significant differences between them (p< 0.34). TB hazard ratio was found to be 62% higher in rural areas (p< 0.001). The standardized incidence rates in urban and rural areas were 31.63 and 51.36 in 100,000 population, respectively. Ramyan and Gomishan had the highest and lowest incidence rats of TB, respectively (77.68 and 14.88 in 100,000 population, respectively).

According to current findings, screening for TB in rural areas in Golestan province is highly recommended. Eastern regions of the province are at greater risk for TB infection due to their ethnic composition (Sistan and Baluchestan immigrants)

Background and Increase in cesarean section (C-Section) is a health system problem around the world. The aim of this study was to compare the rate of C-Section and indications for that before and after implementation of Health System Reform in the hospitals of Mazandaran province, Iran. This descriptive cross-sectional study was conducted analytically. The indications for C-Section were recorded based on curative treatment checklist before implementation of the Health System Reform (2013) and after that (2016). Data were analyzed in SPSS V21 applying t-test and Chi-square. The rate of C-Section was significantly lower only in governmental hospitals after implementation of the Health System Reform (P< 0.05). Among the indications of C-Section, only the previous C-Section had a significant difference before and after the Health System Reform in total hospitals in the province (P<0.002). Significant differences were found between previous C-Section (P<0.025) and its increasing trend, and post-term pregnancy (P<0.027) and decreasing trend before and after the Health System Reform in governmental hospitals. Other indices were not significantly different between public, private, and Social Security Organization hospitals (P<0.05). Implementation of Health System Reform was effective in decreasing the rate of C-section in governmental hospitals. It is hoped that with appropriate implementation of the program, along with cultural and social programs, we could get closer to Iran’s scientific goals and decrease the rate of C-Section according to global standards

Background and Bilingualism is a common phenomenon in many countries which could increase consonant errors in the speech produced by bilingual children. The aim of this study was to evaluate phonological skills such as occurrence proportion, and the frequency and type of phonological processes in Persian-Arabic speaking children in Ahvaz, Iran. A descriptive-analytical cross-sectional study was performed in 28 children aged 36-48 months. The subjects were randomly selected from nurseries in Ahvaz and were divided into two groups (n=14 per group), according to being Persian monolingual or Persian-Arabic bilingual. We used the Persian Phonological Test (PPT), a subtest of Persian Diagnostic Evaluation Articulation and Phonological test which includes 54 one-four phoneme words. The phonological processes were investigated in two groups: structure and substitution processes. Data were analyzed in SPSS applying Mann-Whitney U test. The results showed that occurrence proportion of substitution process was significantly different between the two groups (P=0.05), but the type of phonological processes did not show any significant difference between the two groups. Frequency of phonological processes was found to be higher in bilingual children. In this study bilingualism was found to have no effect on type of phonological processes, but could be effective on frequency of processes. The type of phonological processes in bilingual children is similar to that of monolingual children, so the phonological system in Persian-Arabic bilingual children is similar to that of the monolingual children

Background and Author-assigned keywords at the end of the abstracts in scientific articles are the words most relevant to the content of the article. They are the main sources for indexing and storing the articles in databases, and help to retrieve related articles. Therefore, any mistake or ambiguity in keywords lead to disruption of both data storage and retrieval processes. This study aimed at investigating the types of errors made in author-assigned keywords of articles in the field of medical education. In this descriptive research, the keywords in 13 journals publishing articles in medical education were studied. Out of 3194 articles reviewed, 10965 entries were extracted. The English and Persian keywords were compared using Excel. In the journals studied, the mistakes associated with keywords were made mainly on not writing the equivalent keywords for English keywords and Persian keywords (70.31%). According to current study, the authors, reviewers, and editors are suggested to pay more attention on keywords to prevent disturbance in storing and retrieving the articles

Background and Staphylococcus aureus (S. aureus) produces various toxins. One of the most important toxins is enterotoxin. Enterotoxin A and B play a major role in food poisoning. This research was conducted to determine the enterotoxin A and B genes in S. aureus strains. In this study, 223 specimens were collected from the skin and nose of patients, medical personnel and kitchen staff in Imam Khomeini and Bouali Sina hospitals, Sari, Iran. Culture of samples and biochemical tests were used to detect S. aureus. Polymerase Chain Reaction (PCR) was used to detect enterotoxin A and B genes. Out of 223 specimens, 49 (21.97%) were positive for S. aureus, from which 17 (34.7%) isolates were positive for enterotoxin A gene, while none contained enterotoxin B gene. In this study, isolates of S. aureus were positive for presence of enterotoxin A gene. This bacterium has a major role in causing food poisoning, therefore, its prevalence in hospital strains can lead to secondary infections in patients and should be regarded as a serious threat to community health.

Background and Breast cancer is the most common type of cancer in women and the second cause of cancer death in Iran. Widespread use of mammography and sonography could increase survival in patients with early detection. Sensitivity and specificity of mammography and sonography are different in various sources. This study aimed at assessing the concordance of mammography-sonography reports with pathology reports in tumor size among patients with breast cancer. This research studied 100 women with pathologically proven invasive breast cancer attending Ramsar Imam Sadjad Hospital, 2016-2017. The concordance of mammography-sonography reports with pathology report was studied. Pearson correlation coefficient was applied to investigate the correlations. The mean age of the patients was 48±7.45. Most of them were married with history of labor and breastfeeding. Many patients had BMI>25. In most cases left breast and external upper quadrant were involved and most tumors had ductal pathology. The correlation coefficient between tumor size in mammography and pathology was 0.80 (p<0.0001) and between ultrasonography and pathology was 0.81 (p<0.0001). In most cases, tumor size in mammography and sonography was found to be similar to that reported by pathology. Compared to mammography, sonography was found to be more sensitive in measuring the tumor size which was also more concordant with pathology results.

Background and

Mortality in HIV-positive patients is due to various reasons such as progression to AIDS or co-infection with AIDS and TB or other causes. In survival analysis, competing risk methods are used if there are different reasons for death. The purpose of this article was to identify the factors affecting various causes of death using competing risk methods.

This study was performed in 1231 HIV/AIDS patients attending Diseases Consulting Centers in Tehran between 2004 and 2013. The cause-specific hazard model was used to study the effect of factors on death due to co-infection with TB and AIDS and death by other causes. Data analysis was performed in R software and cmprsk package.

There were 181 patients who were co-infected with tuberculosis and AIDS. The median survival rate in AIDS-TB patients at the time of diagnosis was 6.51 ± 0.66 years and in those with AIDS alone was 11.56 ± 0.98 years. The effects of gender (12.94 [2.81-59.97]), CD4 (0.22 [0.08-0.54]), ART treatment (0.42 [0.24-0.75]), and isoniazid drug prophylaxis (0.08 [0.01-0.6]) were found to be significant on death due to co-infection with AIDS and TB. Also, the effects of sex (3.39 [2.03 -5.66]), CD4 (0.34 [0.22-0.51]), ART treatment (0.32 [0.23 - 0.45]), isoniazid drug prophylaxis (0.5 [0.29 - 0.85]), and Co-trimoxazole drug prophylaxis (0.34 [0.2-0.6]) were seen to be significant on death due to other reasons.

In this study, the cause-specific hazard model was applied to identify the risk factors for all causes of death. Therefore, this method could be used to identify the factors influencing causes of death (separately) and provide solutions to prevent the risks

Background and Diazinon (Dz) is a widely used insecticide. It can cause nephrotoxicity and neurotoxicity by induction of oxidative stress. Edaravone is a drug with antioxidant effect that is used in treatment of acute infraction disorders. In this study we used edaravone for ameliorating diazinon induced kidney and brain damage. Twenty four male Wistar rats were divided into the following groups: Control (normal saline), Dz (150mg/kg) and edaravone (10mg/kg and 20mg/kg) that were injected 30min before Dz. After 24 hr, the animals were anesthetized and the brain and kidney tissues were separated. Then oxidative stress factors were evaluated. Blood serum samples were also taken to determine the levels of BUN, creatinine, and nitric oxide. Dz significantly increased oxidative stress markers such as reactive oxygen species (ROS), lipid peroxidation, protein carbonyl, and glutathione oxidation in kidney and brain tissues. Also, the levels of BUN, creatinine and nitric oxide increased after Dz injection. Interestingly, ederavone administration significantly decreased ROS production in rats’ kidney and brain tissues (p<0.05). It also significantly protected kidney and brain against lipid peroxidation and glutathione oxidation (p<0.05). Edaravone treatment could noticeably inhibit diazinon induced protein carbonyl production in both tissues. Furthermore, edaravone significantly ameliorated the increased levels of BUN, creatinine, and nitric oxide due to Dz administration (p<0.05). These data suggested that edaravone can prevent nephrotoxicity, neurotoxicity and acute toxicity of diazinon via reducing oxidative stress

Dentinogenesis imperfecta (DI) is an inherited disorder affecting dentin. Defective dentin formation results in discolored teeth that are prone to attrition and fracture. Mutation in dentin
and the main gene in this disease is DSPP. Heterozygous mutations in this gene cause tooth sialophosphoprotein (DSPP) causes dentin disorders DI I and II. Imperfecta is a dominant autosomal trait that affects both dual and permanent dental systems. In both sexes, there are clinically yellow-brown teeth and in radiography images, structural defects such as canopy crown and small chamomile pulp are seen. Often, the underlying mineralization defects (bone softness) cause the enamel to wear, which in the second place causes dentin cavitation and abrasion.
This study, reports a 9-year-old child with hearing loss attending the Rasad Laboratory. The patient's blood was studied by the NGS method and the DSPP mutation was identified. To confirm the mutation, a primer was designed for the mutation point and DNA extraction and PCR technique were performed. Afterwards, DSPP gene was sequenced.
Following the sequencing of the genome by the NGS method, heterozygous mutations were found in the DSPP gene. The patient had a defect in dental gene but had completely healthy teeth and a low frequency of hearing. The father of the child was then studied and was found with a heterozygous mutation in the DSPP gene.
The disease is dominant autosomal defect and can also cause deafness in some cases. In this report, the patient had only hearing loss without any symptoms of dental defects

Testosterone is one of the most important male steroid hormones that plays a key role in the development of male reproductive tissues. The secretion of this hormone decreases rapidly after age 50. Hypogonadism in men is a clinical syndrome that is caused by a defect in the production of testosterone, sperm, or both. Several alternative therapies are approved and prescribed according to their efficacy, patient's priorities, and costs. One of these treatments is the transdermal administration of testosterone. In this route, the drug is introduced through attached patch with a drug reservoir, through a permeable membrane, or applied directly on the skin in the form of a gel or lotion. In different countries, testosterone therapy by transdermal administration is rising progressively. Transdermal testosterone delivery by gels or lotions is the preferred method of some men. The pricing level of these transdermal preparations is generally higher than commonly available short-acting injectables, but these user friendly methods are still preferred by many patients. In this study, different types of transdermal preparations, mainly patch, gel, and lotion, as well as a brief overview of buccal and intranasal methods are discussed in details

Background and

Infections caused by multidrug-resistant gram-negative bacteria are rising. Phage therapy is an effective treatment in infections resistant to treatment and progress has been made with its use and development in recent years. Phage therapy in treatment of gram-negative bacterial infections is not well investigated in clinical trials. Therefore, the aim of this study was to systematically review studies on phage therapy against gram-negative bacterial infections.
Methods & Materials: This review was done using electronic databases, including Scopus, PubMed, Google Scholar, and Web of science and articles published from 1968 to 2017 were investigated. Studies meeting the inclusion criteria were selected and estimated using a review method.

A total of 128,009 articles were indexed from which 320 were selected based on their abstracts. Then, some were excluded including experimental studies and In vitro and In vivo studies. Finally, clinical trials (n=23) that met the inclusion criteria and published in English were selected.

This review showed that phage therapy is an effective treatment against gram-negative bacterial infections in humans orally, topically, and subcutaneously injected

MicroRNAs (miRNAs) are small non-coding RNAs that regulate the expression of about 60% of human genomes. Silibinin or mixture of silybin A and B is a flavonolignans that constitute 70-80% Silymarin which is considered to be its main effective ingredient. Silibinin revealed antioxidant and anti-inflammatory effects by scavenging free radicals, improving antioxidant enzymatic activities, and suppressing NF-кβ activation. One of the recent discoveries about the functions of silibinin, is its ability to change different miRNAs expression, especially in cancer. For instance, silibinin decreases Bcl2 level by inhibiting miR-21 expression in breast cancer cells that leads to apoptosis. Silibinin elevates miR-203 expression in lung cancer cells that causes stimulation of E-cadherin. The component can differentiate mesenchymal phonotype to epithelial. Also, treatment of glioblastoma cancer cells with silibinin diminishes anti-apoptosis factor XIAP by upregulation of miR-7 that causes prevention of autophagia in these cells. Therefore, silibinin could induce apoptosis and differentiation and inhibit proliferation in different cancer cells via regulation of various miRNAs expression. In this review study we aimed to summarize the studies about the effects of silibinin on different miRNAs expression in various types of cancer cells to distinguish the exact mechanism of silibinin anti-cancer effects

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease in children. With increasing prevalence of childhood obesity, NAFLD is increasingly seen in children. The prevalence varies according to the population studied (race and ethnicity) and the definition of NAFLD used in the study. In Iran, the prevalence of NAFLD in obese children ranges from 50% to 55% and in the general population of children is about 17%. Most patients with NAFLD are asymptomatic. However, abdominal pain may be present in the right and upper extremity, and hepatomegaly or non-specific symptoms such as abdominal discomfort, weakness, fatigue or attention disorder may also be seen. Diagnostic methods of NAFLD include laboratory tests, biomarkers, biopsy, and imaging studies such as ultrasound, CT, MRI. There is no definitive treatment for non-alcoholic liver disease. Modification of some risk factors such as obesity, diabetes, and hyperlipidemia are often recommended, but weight loss is more beneficial. Early diagnosis of NAFLD in children and its management can reduce further complications. Therefore, in this study, we reviewed the articles published on NAFLD in children (until 2017) using electronic databases, including PubMed, ProQuest, Scopus, and Google Scholar. We reviewed the signs of NAFLD, its epidemiology, etiology, complications, laboratory findings, different diagnostic methods, treatments, and follow up procedures

Background and

Breast cancer is the most common cause of death due to cancer in women throughout the world. There is no absolute way to prevent this cancer, so, screening for early diagnosis is essential. The aim of this study was to review the strategies that promote breast cancer screening behaviors in women.

In this review study, Persian and English articles (published 1985-2017) were searched in electronic databases including Google scholar, SID, Magiran, Pubmed, and Science Direct using the following keywords: strategy, screening behavior, cancer, breast cancer, and women.

In this study, 438 articles were found and after screening the title, abstract, and original text, 39 articles were selected. Based on the findings, effective strategies for promoting screening behaviors in women included self-care trainings in breast cancer, designing cost-effective public screening programs, using reminders to invite women to screen, eliminating fear, and anxiety about screening for breast cancer.

Screening for early diagnosis of breast cancer is of great benefit in performing fast and appropriate treatments, so various strategies should be used to increase screening behaviors in women. These strategies should be promoted using human resources, educational materials, health policies, and psychosocial supports.

Correction to: Effective Factors on Delayed Onset of Treatment in Patients with Acute Myocardial Infarction


Ensiyeh Rezaee1,
Nasrin Hanifi2,
Mahin Rohani3,
Soghrat Faghih Zadeh4

1 MSc Student in Critical Care Nursing, Faculty of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
2 Assistant Professor, Department of Critical Care Nursing, Faculty of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran.
3 Instructor, Department of Critical Care Nursing, Faculty of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
4 Professor, Department of Biostatistics, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran




In the article published in volume 28, issue 163, 2018, the corresponding author’s name was published incorrectly, which is now corrected.

* Corresponding Author: Nasrin Hanifi - Faculty of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran (E-mail: [email protected])