مجله علمی دانشگاه علوم پزشکی کردستان
سال بیست و ششم شماره 2 (پیاپی 112، خرداد و تیر 1400)

Silymarin, obtained from Silybum marianum has hepatoprotective effects and antioxidant activity and has been used in the treatment of liver diseases. Because of its poor aqueous solubility and low bioavailability its use has been limited. The aim of this study was to prepare a new and inexpensive formulation of silymarin using simple dissolution methods and compare its hepatoprotective properties with that of its extract after oral administration.

In this experimental study, an oral solution of silymarin was prepared in the form of nanomissile by a simple dissolution method and some pharmaceutical parameters were evaluated.  A total number of 24 male Wistar rats were randomly divided into 4 groups of 6: control groups (normal control and damaged control) and 2 treatment groups. Treatment groups received silymarin and new oral formulation of silymarin respectively for 14 days before inducing damage by CCl4. At the end of the study, blood samples were collected to determine serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and lipid profile. In addition, malondialdehyde (MDA), nitric oxide (NO) levels and activities of catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx) activities in hepatic tissue were assessed.

The new oral solution of silymarin characterized by in-vitro release = 72%, entrapment efficiency (EE) =82%, and zeta average (d.nm) =227.5 was prepared within 48 hours. The activity of ALT and 0AST liver enzymes and the level of lipid profile parameters were significantly decreased in the nanomissile treated group compared to those in the silymarin-treated group (P<0.05). Also, the activities of liver antioxidant enzymes SOD and CAT in the nanomissile treated group showed a significant increase compared to those in the silymarin extract-treated group (P<0.05). The level of the liver MDA was significantly decreased in the nanomissile group compared to that in the silymarin extract group (P <0.05).

Analysis of the biochemical and antioxidant parameters of this study showed that the new oral formulation of silymarin led to more reduction of toxic effects of CCl4 and, hence, better hepatoprotective effects compared to the extract of silymarin

The vast applications of nanotechnology in various fields including medicine, bring about the necessity to investigate the in vivo side effects of these materials. On this basis, we investigated the potential anti-diabetic activity of nanoparticles (NPs) along with toxicological effects on liver and pancreas tissue.

In this excremental research after preparation of ZnO nanoparticles and their characterization with SEM, EDX, and TEM, 30 rats were studied in 6 groups of 5 each. The groups included 1- Healthy control 2- Diabetic control 3- Diabetic - Insulin (10 U/kg) 4- Diabetic - Cranberry (150 mg/kg) 5- Diabetic-ZnO (8 mg/kg) 6- Diabetic-ZnO + extract (8 mg/kg). Diabetes was induced with alloxan monohydrate via intraperitoneal injection (170 mg/kg). Rats were treated intraperitoneal for 16 days and every four days examined for blood glucose levels, at the end of the treatment period, the liver and pancreatic tissues were analyzed by hematoxylin-eosin staining. Data were analyzed using two-way ANOVA and Tukey post hoc tests in SPSS.

The analysis of nanoparticles revealed the capping of organic constituents on the surface of the biological nanoparticles. The assessment of serum samples displayed a significant decrease in blood glucose levels in the group that was treated by NPs prepared by extract when compared to that of the diabetic control group (p≤0/05). The histopathological analysis did not show any damages to the studied organs.

The results obtained in the present study revealed that the bio-synthesized nanoparticles not only significantly decreased the blood glucose level of diabetic rats but also had no toxic effects on the liver and pancreas tissues at the concentrations used in this study.

Anal fissure is one of the common anorectal disorders that there are various therapies for it. The aim of this study is to evaluate the effect of Nitroglycerin plus Diltiazem vs either of topical Diltiazem and Bethanechol alone in the treatment of chronic anal fissure.

The present randomized double-blind clinical trial was performed on 90 patients with chronic anal fissure referred to gastroenterology clinic of Tohid Hospital, Sanandaj, Iran, from March 2016 to February 2017, That randomly were divided into three equal groups (n = 30): A: combination therapy (1% Nitroglycerin plus 5% Diltiazem gel), B: Diltiazem (5% Diltiazem gel) and C: Bethanechol (0.1% Bethanechol gel). The drugs were administered topically three times daily for 8 weeks. After 4 and 8 weeks’ administration wound condition, pain and bleeding was assessed. Data were analyzed by SPSS v.19 software with Chi-square test.

At the beginning of the study, there was no significant difference in mean of age, sex, fissure location, hemorrhoids, bleeding and pain between the three groups (P> 0.05). Four weeks after treatment, there was no significant difference between the three groups in terms of the Wound healing (P = 0.41), pain (P = 0.10) and bleeding (P = 0.07). After 8 weeks, there was a significant difference for pain in the treatment groups (P = 0.04), so that in the diltiazem group, pain was significantly decreased in comparison to Betanchenol and There was no significant difference between the three groups in the case of Wound healing (P = 0.10) and bleeding (P = 0.69).

Topical use of diltiazem is a more appropriate option for treatment of chronic fissure than other two drugs.

X-ray and gamma-ray are part of the electromagnetic waves that can penetrate into living tissues, ionizing radiation can lead to abnormal function. Despite radiology students could be exposed to ionization radiation during received training,   their radiation dose has not evaluated. The purpose of this study was to compare the blood factors and thyroid hormones in  the senior and freshman radiology students

case-control study was performed in May-July 2018. the sample size has consisted of   60 freshman and senior radiology students (30 freshman and 30 senior radiology students) who were healthy and have not has blood diseases. Eventually, The blood factors of students were analyzed in the laboratory.

measuring blood factors such as white blood cell, erythrocyte, basophil, neutrophil, platelet, hemoglobin but the mean basophil, lymphocyte, T4, and TSH  showed that  Ionizing radiation causes significant changes in basophil, lymphocytes, and thyroid hormones (T4 and TSH ) in two groups of students, but there was no significant difference in others blood factors between two groups (P<0.05).

Ionizing radiation caused changes in some blood factors ( basophil, lymphocytes, and thyroid hormones (T4 and TSH ) ) .therefore,  the survey of radiology division and raising safety and awareness of student is recommended.

Thyroid hormones play an important role in the development and maturation of the central nervous system before and after birth. There is not enough scientific evidence about the effect of subclinical hypothyroidism on neurocognitive development in offsprings. This systematic review was conducted to assess the effect of maternal subclinical hypothyroidism on the neurocognitive development of children.

In this systematic review, the PubMed, Web of Science, and Scopus databases as well as SID, Irandoc, and Magiran (Persian databases) were searched for the English and Persian related articles using appropriate keywords. In the current systematic review, of 411 records obtained through primary searching, 9 eligible cohort studies were evaluated. The quality of articles was assessed using the Newcastle-Ottawa scale.

Different studies have used different scales to evaluate the neurodevelopment of offsprings with different age ranges at the time of assessment. The results of 5 of the 9 selected studies indicated a lower IQ and neurodevelopment scores in the children born to mothers with subclinical hypothyroidism than in those born to euthyroid mothers. In four studies, there was no difference in neurodevelopment scores in the offsprings between the two groups.

There is no consensus about the impact of maternal subclinical hypothyroidism on neonatal neurodevelopment. Considering the limitations of the current methods for assessment of neurocognitive development of children, the use of new biochemical parameters for precise and early evaluation of neurocognitive development in offsprings should be taken into consideration.

One of the most common complications of brucellosis is its skeletal manifestations. This study was performed to identify the different types of skeletal manifestations in the patients with  brucellosis.

We reviewed records of the patients with skeletal complications of brucellosis who had been admitted to the infectious diseases ward of Razi Hospital in Qaemshahr from 2011 to 2017. Using SPSS 21 software, data were analyzed by t-test and chi-square (p≥0.001).

In 300 patients with brucellosis, the most frequent cause of referring to the hospital was fever (82.33%). The most, common skeletal complication was lumbar spondylosis. The mean value for hemoglobin was 11.50±1.57 gr/dl in women and 12.34± 1.54 gr/dl in men. Elevated alkaline phosphatase (97%) was the most common laboratory finding. This disease was more common in men than in women which showed a statistically significant difference (p≥0.001). The mean erythrocyte sedimentation rate was 52.78±29.15 millimeters per hour in the women (p≥0.001).

Fever and back pain were the most common causes of referring to the hospital. The most common articular bone complication was spondylosis, which was more common in the middle-aged patients. Therefore, brucellosis should be considered as a differential diagnosis in the patients with long-standing fever and also in those with low back pain and arthralgia.

Considering widespread use of vancomycin in childeren and the occurrence of phlebitis related peripheral intravenous catheters (PIVC); we decided to determine Predisposing factorsof phlebitis in the childeren receiving vancomycin.

Methods and Materials: 

This cross-sectional descriptive-analytic study included 145 children older than 1 month who had been admitted to a medical education center in Isfahan and were under treatment with vancomycin. The sampling method was convenience and phlebitis measuring instruments were used 24, 48 and 72 hours, after the peripheral intravenous catheter insertion for every child. Chi-square test and multinomial logistic regression tests were used to analyze the data.

Chi-Square test showed a significant relationship between phlebitis and catheter place, catheter size and washing catheter with 0.09%NaCl (p<0.05). Multinomial logistic regression indicated that age (p=0.009), male gender (p=0.009), catheter placement in upper extremity (p=0.005), catheter No.24 (p=0.04), washing catheter with 0.09%NaCl (p<0.001), vancomycin concentration of <5mg/ml (p=0.004) and infusion of total peripheral nutrition (p=0.017) and cephalosporins (p=0.025) significantly influenced incidence of phlebitis.

nurses can prevent phlebitis by selecting appropriate catheter considering the ratio of catheter to vein size, washing catheter with 0.09%NaCl and use of the upper extremities for catheter insertion. The concentration of vancomycin should also be <5 mg/ml and the infusion rate should not exceed 5-10 mg/min. These factors have considerable importance when childeren receive total peripheral nutrition and cephalosporins along with vancomycin

Bipolar disorder type 1 is a chronic, debilitating and recurrent disorder that is defined by specific periods of mania and this disorder causes a great deal of intrapersonal and interpersonal disorder. Overall, the present study aimed to investigate the effectiveness of dialectical behavior therapy based on emotion regulation skills training on impulsivity and how to cognitively regulate emotion in type 1 bipolar patients.

The present study was based on quasi-experimental studies with pre-test-post-test design with a control group. The statistical population of this study consisted of all male patients admitted to Razi Hospital in Tabriz in 2018. A purposeful sampling method was used to obtain a statistical sample (30 people); Also, to reduce the difference between the groups, the sample was randomly divided into experimental and control groups. In order to obtain the research data, Barthes Impulsivity Questionnaire and Gabreski Emotion Cognitive Emotion Regulation Strategies were used. To analyze the obtained data, multivariate analysis of covariance with SPSS- 24 statistical software was used.

The results of statistical studies showed that dialectical behavior therapy had a significant effect (p <0.05) on improving impulsivity and cognitive emotion regulation strategies (except blaming others and refocusing on planning, accepting, and adopting other perspectives) of bipolar patients.

The findings indicated that dialectical behavior therapy based on emotion regulation skills training can be used to reduce impulsivity and cognitive emotion regulation in patients with type 1 bipolar disorder in combination with medication.

Covid-19 is spreading in the world and the governments are taking further steps to curb the rate of virus infection. An increase in the number of cases of Covid-19 has led to a challenging condition and we have to decide to decrease or stop elective surgeries.

Using keywords of elective surgery, emergency surgery, coronavirus, Covid 19, we searched Persian and international databases (SID Magiran, Iranmedex, Google Scholar, Medline, Scopus, Elsevier, Pubmed, Sciencedirect) for the related English or Persian studies. Finally, we selected 31 articles.

All hospitals and surgeons must draw up a plan to limit, postpone or cancel elective scheduled operations, endoscopy, or other invasive procedures until the necessary health care facilities and measures for the patients are available.

During the current Covid-19 epidemic protection of hospital resources such as hospital beds and ICUs, respirators, and patients and staff is necessary. It is recommended that hospitals stop elective surgeries. Accurate clinical judgment should be considered as the determinative factor in performing operations

Past studies have shown that self-esteem (SES) and self-efficacy (SEF) have a positive and significant relationship with the improvement of the patients. On the other hand, it has been proved that mindfulness improves the patientchr('39')s health. Yet, the relationships between these three variables have not been investigated enough. The aim of this study was to investigate the relationship of mindfulness with SES and SEF in patients with severe psychological problems.

This analytic-descriptive study included all eligible patients. After informed consent (213 participants), necessary data were collected and we used Cognitive and Affective Mindfulness Scale-Revised (CAMS-R), Rosenberg’s Self-Esteem Scale, Mindfulness-based Self-Efficacy Scale-Revised (MSES-R) in this study. Using the 20th version of SPSS software, data were analyzed by descriptive statistics, Pearson’s coloration coefficient, independent t-test, and simple linear regression.

Among 213 patients, 151 were male (%70/7), and 62 were female (%29/3). The mean age of the participants was 32 ± 10/04. Linear Regression showed a positive and significant relationship between variables (mindfulness with SES r =.489, mindfulness with SEF r =.307. Also, we found that we could predict a significant alteration in mindfulness by self-efficacy and self-esteem.

It seems that mindfulness has a reciprocal relationship with SEF and SES which can have an influence on the effects of each other. It is likely that SES and SEF are among the factors which are associated with the effectiveness of the mindfulness-based therapies

Traffic and its related problems are among the most important public health concerns in the world and prevention of these problems are necessary. GSEM model is a method to test theoretical models and causal modeling exactly. The objective of the present study was to investigate the predictors of injuries leading to hospitalization of motorcyclists considering MRBQ as a mediator in this case-control study, using a generalized structural equation modeling (GSEM).

In this case-control study, we selected 303 cases (motorcyclists admitted for a traumatic condition) and 153 controls (motorcyclists admitted for a non-traumatic condition) using a cluster random sampling method in Tabriz, Iran. We used a motorcycle-riding behavior questionnaire (MRBQ), Attention-deficit/hyperactivity disorder (ADHD) questionnaire, and a researcher-made checklist. GSEM model was used to examine the direct linear and indirect linear relationships of variables in the conceptual model, considering the binary response variable of the model. Data analysis was performed by STATA14 software.

The predictors of injury were: MRBQ, ADHD, and demographic characteristics. The results indicated significant linear and direct relationships between odds of injury and cell phone answering (OR= 2.22, P= 0.010), hyperactive child (OR= 1.65, P= 0.057), dark hour riding (OR= 1.01, P= 0.001) and MRBQ (OR= 1.27, P= 0.092), while there were significant inverse relationships between injury and marital status (OR= 0.43, P= 0.002), and academic education (OR= 0.29, P= 0.001).

According to the results of our study, intervention programs on the ADHD, use of cell phone while driving, and dark hour riding are highly recommended

According to the WHO Commission on social determinants of health, identification of social determinants of health and collection of scientific evidence in this domain is essential for reducing health inequity. This is considered one of the main missions of social determinants of health research centers. The aim of this study was to evaluate the status of knowledge production in the county SDH research centers in Iran.

In this 5-year cross-sectional study (2014 – 2018) 33 SDH research centers were assessed in regard to knowledge production indicators such as published articles, citation, H index, the high-quality publication (Q1), and international collaborations.

We found 4229 indexed articles which have been published by 334 faculty members/researchers of these research centers from 2014 to 2018. 11.9 percent of these articles have been published in high-quality research journals and 488 articles were produced with international collaboration. In 2018, the total number of citations to these articles published by these research centers from 2014 to 2018, was 4427 and the highest five-year H index was 26. According to the results of the research rankings, social determinants of health research centers of Kermanshah, Kurdistan, and Qazvin were ranked first to third, respectively.

The trend of knowledge production in Iranian social determinants of health research centers has paralleled the trend of their citations and it is necessary to pay more attention to high-quality journals for publication of articles and expansion of international collaboration. Obviously, producing scientific documentation can be an effective source in health promotion policies and reduction of access gradients