نشریه دانشگاه علوم پزشکی البرز
سال یازدهم شماره 2 (بهار 1401)

In recent years, there has been significant increase in the number of diabetic patients, the rate of hospitalization and non-traumatic lower limb amputation. The last two mentioned are known as the major complications of diabetes.  In addition to it, there has been a considerable tendency among the medical therapist in applying  apitherapy a branch of alternative medicine that deals with natural agents containing effective chemical compounds in this specialized field. Following what was explained we decided to reexamine the effects of Bee pollen as a natural support to promote the process of diabetic pressure ulcer healing.

This study is a one-blinded clinical trial study included 84 diabetic patients suffering from diabetic ulcers. These patients were referred to the wound clinics under supervision of Alborz University of medical sciences in Karaj. The study group was divided into two groups: experimental group (E.G), the patients who were given Bee pollen and control group (C.G.), those whom were given placebo .patient educated to solve one tea spoon powder in milk or water  three times a day and drink, preferably before meals. Equal care was provided to all patients by wound experts over a twelve week period of time. During this time the PUSH questionnaire was completed for each patient by wound experts twice weekly.

To match the research, we selected these two groups from similar demographic variables such as: age, gender, education, marital status, underlying disease, body mass index, fasting blood sugar, hemoglobin and the size of the wounds. Comparing the PUSH score at the end of sessions 6, 12, 18 resulted in lower scores in E.G., while at the last session of 24 the PUSH score in C.G. was reported lower than E.G.Yet, no significant difference between the two groups was founded.

In this study, Bee pollen as a nutritional supplement in diabetic ulcer healing stimulation has not been proved. Hence, more studies are needed.

Autoimmune diseases (ADs) are chronic conditions characterized by the loss of immunological tolerance to self-antigens. ADs are not rare and show variable patterns in different countries. In this study, we aim to investigate the prevalence of autoimmune disorders and pattern of polyautoimmunity among Iranian children with endocrinopathy.

Overall 45 patients with early-onset multiple autoimmune disorders were enrolled in the study and data was collected via a questionnaire. All statistical analyses were performed using SPSS software (v. 26.0, Chicago, IL). The statistical significance level was set at P < 0/05.

Forty-five patients (15 [33/3%] male and 30 [66/7%] female) with early-onset polyautoimmunity were included in the study. The most prevalent ethnic groups were Persians (51/2%) and Azeris (39/0%). The median age at the time of evaluation and the onset of autoimmune symptoms were 12.0 and 6.0 years, respectively. Most patients (58/5%) were born to non-consanguineous parents. In 23 (54/8%) patients a positive family history of autoimmune disorder was reported. The autoimmune disorders mostly included insulin-dependent diabetes mellitus (IDDM) in 39 (86/7%) patients, celiac disease in 29 (64/4%) patients, and autoimmune thyroiditis in 20 (44/4%) patients. The most frequent overlap in autoimmune disorders was present between IDDM and celiac (n=25, 55/6%) and then IDDM and autoimmune thyroiditis (n=15, 33/3%).

In the current study, the most common autoimmune disorder was IDDM, which was mostly in overlap with celiac disease. This finding further highlights the importance of precise follow up of IDDM patients for celiac disease which can lead to earlier diagnosis and positively impact the evolution of complications.

birth body size is an indicator of intrauterine growth and important in later health. this study was performed to assess seasonal variation of birth body size in a group of Iranian newborn.

in a retrospective design, Hospital records of 2034 of singleton newborn with gestational age >37 week and no malformation or neonatal disorder, was assessed sex delivery type birth month, birth weight, birth height, head and chest circumferences was extracted.

1038 cases (51%)of neonates were male and 692 cases (34%) born in natural vaginal delivery. no significant difference was found in seasonal mean of birth weight (p=0.285) although most mean off birth weight was in Winter and least in summer. but peak of birth height was in fall and the least in summer (mean difference: 0.40; 95% CI:0.06-0.74; p=0.013). the difference between mean of birth head circumference was significant(p=0.027) and the most mean was in Winter and least in summer (mean difference : 0.24;95% CI:0.02-0.46; p=0.030). the difference between mean of birth chest circumference was significant and the most and least mean was in fall and spring; respectively (mean difference: 0.42;95% CI:0.12-0.71; p=0.002).

birth body size is the least in newborn of  hot half of the year and most in cold holf of the year.

Hemodialysis can have adverse effects, such as increased blood phosphorus in these patients. Considering the fact that hemodialysis does not affect the blood phosphorus in dialysis patients and in order to improve the quality of life in these patients, this study was conducted to determine the incidence of hyperphosphatemia and its reduction strategies in children undergoing hemodialysis.

This descriptive cross-sectional study was performed on 30 children undergoing hemodialysis in Sheikh's Children's Hospital in Mashhad. The incidence of hyperphosphatemia was measured by blood test of the patients. Data were collected using a questionnaire and analyzed by SPSS software.

In this study, 30 children were studied; 36.7% were girls and 63.3% were boys. 86.7% were hemodialysis for 3 sessions per week. The mean serum concentration of phosphorus in the first three months of the year was 6.8 mg / dl and the second quarter of 97 was 35 mg / dL.

According to the results of the second quarter of 1997, the mean serum concentration of phosphorus in children undergoing hemodialysis increased by 28.2 mg / dl compared to the same period of the first month of the year. This is while the calcium and phosphorus product, which is more important, has been reduced by 3.4 mg / dl after corrective action; therefore, this diet can be partially offset by increasing the amount of phosphorus in the blood.

Fecal incontinence is one of the secondary and serious complications following anorectoplasty operation in the children with Imperforated Anus. Complete rectal dislocation and local spinal defect of the sphincter muscle are the main causes of fecal incontinence in people undergoing surgery for Imperforated Anus.

This retrospective descriptive Case-Series study was performed during 2015 to 2020 at Maryam hospital. Data were collected by a checklist that was designed by the research. The collected data were analyzed by SPSS software version 23. Descriptive analysis was used to analyze the qualitative variables while quantitative variables were summarized using mean and Standard Deviation (±SD). 

The mean age of patients was 9.65 years and the standard deviation (±SD) was 7.45 (2-33 years). Fecal incontinence is the most common side effect after Sphincteroplasty for treatment of "Imperforated Anus" following anorectoplasty. The success rate of surgery in this study in the recovery of patients with fecal incontinence after anorectoplasty for patients with imperforated anus is 74% after 6 months and 89% after 2 years.

The most common causes of fecal incontinence following anorectoplasty were rectal displacement as well as ano-rectum misplacement between the sphincter muscle and annular sphincter defect. In patients with history of anorectoplasty, annular sphincter defects were most often seen at rejoins 12 and 6 o'clock (Superior and Inferior). It is necessary that surgeons pay more attention to repairing these points in order to prevent the incidence and recurrence of fecal incontinence.

Patients with epilepsy and with bipolar mood disorder usually are treated with anticonvulsant drugs; and this is due to similar neurological, electrophysiological, and chemical mechanisms, by which both of the disorders can be described. However, these two types of disorders are classified differently under the titles of either neurological or psychiatric disorders. The aim of this study was to investigate the effect of “Sodium Valproate” as an anticonvulsive drug on the electrophysiological signs in the epileptic and bipolar patients.

The study is a quasi-experimental one, in which 40 patients with temporal lobe epilepsy, and 40 patients with bipolar mood disorder were participated. The patients were selected accidentally from Paknejad clinic in Tehran, and Baryab psychiatric center in Ardabil, in 2016-2017. They were diagnosed by psychiatrist and were under the treatment by sodium valproate. Data were analyzed using descriptive statistics (mean and standard deviations) and inferential (ANCOVA covariance analysis) and analyzed using SPSS21 software. Meanwhile, for all hypotheses, a significant level of α = 0.05 was considered.

The findings showed that there was a significant difference in the use of sodium valproate between the two experimental and control groups regarding the use of anticonvulsant drugs. This drug has been shown to change the characteristics of the electroencephalograms in patients with epilepsy and bipolar disorder, and in each group, a significant reduction in the pattern The patient is EEG (the effect is 233.0). Also, sodium valproate reduced the level of depression in patients (P = 0.008 and F = 3.695).

The findings of this study indicate that anti-seizure effect of sodium valproate on reducing abnormal brain waves and decreasing the rate of depression in both epileptic and bipolar patients. Meanwhile, it became clear that bipolar patients have more electrophysiologic activity in the right hemisphere of their brain. These results support a kind of hypothesis of forgery.

The invasion of microorganisms into the bloodstream and spread to different parts of body can cause disruption the functions of vital organs and even death. This study aimed to evaluation of positive blood cultures in patients suspected to septicemia admitted to the Imam Khomeini Hospital in 2013-2016.

  In this study, blood samples of patients were cultured and isolated bacteria were identified using standard methods. Antibacterial susceptibility testing of isolated bacteria to selected antibiotics was performed using disk diffusion method based on Clinical and Laboratory Standards Institute (CLSI) recommendations. Data were analyzed using SPSS 22 software and frequency distribution table.

The results showed 6.6% of the blood cultures were positive for bacteria. Isolated bacteria were 63.5% gram-positive and 36.5% were gram-negative bacteria. In our study, the most common micro-organisms in general were as follows: Staphylococcus coagulase negative (49.85%), Klebsiella Pneumonia (9.46%), Acinetobacter baumannii (8.33%) and Staphylococcus aureus (7.77%).  Gram-positive organisms have the highest resistance to Ampicillin, Ceftriaxone, Erythromycin and Cefazolin. In general, there was the highest resistance of gram-negative organisms to Cefazolin, Ceftriaxone and cefepime.

With appropriate antibiotics prescription, according to exact results of antibiogram and with sanitation in various parts of hospital, especially the neonatal’s part, can be proceed accurate treatment and reduce health costs.

Diabetes is one of the most important health problems in the world, and controlling its risk factors and complications is very important. The aim of this study was to determine the effects of interval training on inflammatory markers among type II diabetic patients.

in this randomized controlled trial 30 eligible patients randomly allocated to one of two parallel groups. Fifteen patients received interval training exercise with 18 sessions (three sessions per week), and fifteen patients in control group had usual physical activity. The primary outcome was measured before and after the intervention.

Interleukin-10 levels were significantly reduced (reduction: 0.96 pg/ml) in patients in the intervention group and increased (0.35 pg/ml) in control group, and this difference was statistically significantly between group (p: 0.015). The levels of interleukin-6 and CRP in the pre- and post-measurement measurements of the two groups did not show a significant difference (p>0.05).

Interval training exercise can be effective in reducing some inflammatory factors, and given that these factors affect the course of the disease and complications associated with diabetes, the use of this type of exercise can be useful for controlling the disease and its complications. More investigation in interval training exercise and its effects on various inflammatory factors are required.

Today, the issue of staff empowerment is in the spotlight because capable, skilled and better motivated staff will be able to adapt to change. Also, capable behaviors in hospitals can lead to improvements in health care.

The research was conducted to validate the model of empowerment of midwives working in the maternity ward of Tehran teaching hospitals. To validate 20 specialists and experts in gynecology and midwifery and educational management by purposeful sampling method and 135 midwives who working in the maternity ward of educational centers in The city of Tehran was selected by stratified random clustering. The data collection tool was Strauss and Karbin 5-point Likert questionnaire. SPSS 22 software and inferential statistical tests such as one-sample t were used to validate and evaluate the model.

In model validation, the components of adaptability, comprehensibility, generalizability and control were above average with an average of 4/55, 4/55, 4/45 and 4/60, respectively, and expressed the internal validity of the model according to experts.Also, for midwives, the components of adaptability, comprehensibility, generalizability and control were above average with an average of 4/21, 4/23, 4/03 and
 4/05, respectively, and indicate the internal validity of the model from the users' point of view.

The model is valid for experts and users and can be used in maternity wards of teaching hospitals.

Diabetes is a metabolic disease associated with hypoglycemia, hypolipidemia, and liver dysfunction.The aim of this study was to evaluate the effects of hydroalcoholic extract of black seed and honey (dozin) on liver enzymes (AST, ALT, ALP) in streptozotocin-induced diabetic rats.

70 adult male rats weighing approximately 220-200 g were divided into 7  groups: Control group: did not receive any medication. The sham  group received only solvent.  Experimental group 1 and 2: Animals in this group received 2 and 4 g / kg of hydroalcoholic extract of black seed and honey (dosin), respectively. Experimental group 3 received streptozotocin intraperitoneally as diabetic group : Animals in this group received 70 mg / kg of streptozotocin intraperitoneally, experimental group 4 and 5,  Animals in this group first received streptozotocin and then 2 and 4 g / kg of extracts. Rats  were treated for 21 days and at the end of the experimental period, blood samples were collected and serum levels of liver enzymes (AST, ALT, ALP) were measured.

The results show that the levels of AST and ALP enzymes in experimental groups 5 and 4, respectively, compared with experimental group 3 (diabetic group l) and in experimental groups 1 and 2, compared with control and sham groups, showed a significant decrease at the level of p <0.05. In experimental group 3 (diabetic group), the levels of AST and ALP enzymes showed a significant increase compared to control and sham groups.

This study showed that the hydroalcoholic extract of black seed and honey (dosine) probably improves the destructive effects of diabetes on changes in liver enzymes due to its antioxidant properties.

Klebsiella pneumoniae is one of the most important hospital opportunistic pathogens that have become resistant to many antibiotics due to biofilm formation. The aim of this study was to synthesize copper nanoparticles using Artemisia scoparia extract, to investigate its antimicrobial and anti-biofilm effects against K. pneumoniae strains.

In this experimental study, 100 clinical samples were collected from different hospitals in Tehran. K. pneumoniae strains were isolated from clinical specimens using microbiological methods. Subsequently, the synthesis of copper nanoparticles was performed by green synthesis method using A. scoparia extract and its properties were examined by scanning electron microscopy (SEM), transmitting electron microscopy (TEM) and X-ray diffraction (XRD) methods. The antimicrobial and anti-biofilm effects of the synthesized copper nanoparticles were investigated and the effect of copper nanoparticles on the expression of mrkA biofilm gene in K. pneumoniae strains was investigated by Real Time PCR.

A total of 20 K. pneumoniae strains were isolated from 100 clinical specimens. SEM TEM and XRD results showed that the synthesized copper nanoparticles had a spherical shape and a size of less than 100 nm. The results showed that copper nanoparticles had significant antimicrobial and anti-biofilm effects against K. pneumoniae strains and copper nanoparticles could significantly reduce the expression of mrkA biofilm gene (p <0.05).

The results of this study showed that the synthesized copper nanoparticles have significant antimicrobial and anti-biofilm effects. Therefore, this nanoparticle can be used as a drug candidate in future studies.

The use of antimicrobial properties of medicinal plants can solve the problems associated with the use of antibiotics. The aim of this study was to evaluate the antibacterial property of Oregano hydro alcoholic extract on pathogen bacteria by microplate in laboratory conditions.

The aim of this study was to evaluate the antibacterial properties of hydro alcoholic extract of oregano on pathogenic bacteria by microplate method in vitro. 

After collecting oregano, they were dried in a place by sunlight and in shade for 48-48 hours, and extraction was carried out by maceration, in order to determine the amount of inhibition (dilution) inhibitor The Muller-Hinton broth was used. The turbidity rate was evaluated in the wells method (microdilution).

The results of microdilution test showed that the minimum inhibitory concentration of extract on Escherichia coli in the first (lµ50), the concentration of extract on salmonella typhimurium in the first (lµ50), the concentration of Klebsiella pneumonia in the second (lµ25) , Concentrations of Pseudomonas aeruginosa in the sixth poison (lµ1.56), concentration of Bacillus cereus in the eighth grade (lµ0.39), and the minimum concentration of Staphylococcus aureus in the tenth (without growth) strain.The results showed that Oregano essential oil has antibacterial properties and can be used as a cheap and available source for therapeutic applications in some bacterial infections. In other words, Oregano can be considered as an alternative to synthetic antibiotics to combat the isolates tested. Of course, all the effects of these extracts should be carefully investigated in vivo and in vitro.

Hydatid cyst disease (Echinococcosis) is caused by species of the parasite genus Echinococcus. The infection is present in many countries where animal husbandry is common. The treatment of the disease was based on surgery, which was accompanied by an adjunctive drug treatment. It is harmful to use the protoscolicidal effect of parasites during surgery to reduce the recurrence of the disease. The aim of this study was to confirm the protoscolicidal effect of nanoparticles of silver oxide, methanolic and acetonic extracts of Gal Ghalghaf due to the antimicrobial effects of plant in vitro on hydatid cyst protoscolices.

Echinococcus granulosus protoscolices were collected from 60 liver of sheep infected with hydatid cyst. The hydatid cyst fluid was drained using a syringe and concentrated after centrifugation. The lethal effect of normal saline group of 0.9% and the first, second and third groups with concentrations of 0.1, 0.01 and 0.001% of silver oxide nanoparticles and methanolic and acetone Gal Ghalghaf extracts and their integration on protoscolices, respectively. Hydatid cysts are determined at exposure times of 1, 5, 10, and 20 minutes. After data collection, the obtained data were analyzed using SPSS software.

Among the examined extracts, the concentration of 0.1% nanoparticles of silver oxide in 20 minutes and the combination of nanoparticles of silver oxide and methanolic extract of Gal Ghalghaf in 20 minutes had the most protoscolicidal effects, respectively. Also, the lowest lethal effect was obtained at a concentration of 0.001 nanoparticles of acetonic extracts of Gal Ghalghaf at 1 minute.

The findings of the present study showed that methanolic and acetonic extracts of Gal Ghalghaf after combining with silver oxide nanoparticles, especially methanolic extract, can be used as a suitable protoscolicidal agent during hydatid cyst surgery using PAIR (Puncture, Aspiration, Injection, and Re-aspiration of protoscolices).

 The purpose of this report was to review the status of dental care provision in the world and Iran.

 Using the available data and information related to the status of dental services in Iran, such as the results of important national studies, including household income cost, utilization studies, etc., the system of dental services provision in Iran was evaluated and the weaknesses and strengths of this system were investigated in a comprehensive manner.

  The role of medical insurance is very important in reducing inequality. The insurance system should be reformed to improve the coverage of dental services and encourage a preventive approach to oral health services. Further research is required to develop standards in order to promote the quality of dental practice in the Islamic Republic of Iran through using global standards and adapting these standards to the health conditions and policies of the country to maximize the participation of stakeholders and enhance the implementation acceptance. Considering the availability of evidence-based methods and better practices for dental caries and the prevention of periodontal diseases, it is expected that all individuals, especially the prioritized target groups in Iran, will benefit the most in the future.

 With continued efforts in this area and considering the principles of autonomy and the right to choose as well as the importance of achieve the general policies of the system in this field, the access of all people in the country to safe, effective, and logical dental care should be facilitated.

Complex partial seizures are known as focal seizures with impaired awareness. Excluding the first year of life, complex partial seizures are the most frequent type of seizures in patients with epilepsy. A detailed history of the patient and family members is a vital element in diagnosing seizures. Although rare, psychotic and anxiety symptoms in individuals may be the result of the seizure. A 7-year-old boy referred to our hospital emergency room complaining of fear, crying, screaming, and the imminent death sensation and decreased consciousness. The patient's symptoms started two years ago. He was treated with Risperidone and with the impression of ADHD and anxiety disorder. The patient's laboratory tests were unremarkable. A brain MRI was performed with a seizure protocol, with no pathological findings. EEG was then performed for the patient, which confirmed focal seizures with impaired awareness. The patient was prescribed carbamazepine and phenytoin, and Risperidone was stopped.