مجله دانشگاه علوم پزشکی مازندران
پیاپی 208 (اردیبهشت 1401)

One of the common complications of diabetes is impairment of wound healing. The aim of the present study was to investigate the synergistic effect of hyperbaric oxygen (HBO) therapy and decellularized human amniotic membrane (dHAM) in healing of full-thickness diabetic wounds in rats.

In this experimental study, 60 diabetic male rats were randomly divided into four groups (n=15) as follows: untreated diabetic wound, wound treated with HBO, wound treated with dHAM, and wound treated with HBO+dHAM. Sampling was performed after 7, 14, and 21 days following wounding. Assessments included wound closure rate, histological (collagen density) and stereological examinations, expression of genes involved in repair and angiogenesis (TGF-β and VEGF), inflammatory genes (TNF-α and IL-1β), and wound tissue biomechanical properties.

Combined use of dHAM and HBO significantly increased wound closure rate, new epidermis and dermis volume, fibroblast cell and blood vessel density, collagen density, repair and angiogenesis genes, and wound biomechanical properties compared with those in the diabetic group (P<0.05). Also, the expression level of inflammatory genes and neutrophil density significantly decreased in all treatment groups, especially in HBO+dHAM group compared with the diabetic group (P<0.05).

dHAM and HBO had a greater effect on the healing process of diabetic wounds when taken together than when each was taken separately.

Recurrent implantation failure is one of the problems associated with in vitro fertilization cycles. The aim of this study was to evaluate the results of pregnancy using intralipid infusion in infertile women with history of two implantation failures.

A clinical trial was conducted in 80 infertile women in the infertility center in Sari Imam Khomeini Hospital, Iran 2020. In all samples, the level of peripheral blood natural killer (NK) cells was measured two weeks before the intervention using flow cytometry. The participants were divided into an intervention group (n=40) and a control group (n=40) by SAS statistical software. Two days before embryo transfer, patients in intervention group underwent intra lipid infusion (2 ml of 20% solution in 250 ml sterile saline) for two hours and the control group received normal saline (250 ml) infusion. Clinical pregnancy (detection of fetal heart rate by ultrasound) rate was compared between the two groups. Data were analyzed using Chi-square, Mann-whitney, and t-test.

Clinical pregnancy rate was higher in intervention group after intralipid infusion (30%) compared with the control group (10%) (P=0.025). There were no significant differences between the two groups in the level of NK cells and peripheral blood lymphocytes (P<0.05).

Intralipid infusion improved clinical pregnancy rate in women with history of recurrent implantation failure. However, further studies are required on the possible mechanism of immunological effects of interlaipid in NK cells.

Cough, hoarseness, and sore throat are complications of intubation. The aim of this study was to evaluate the effect of gargling with honey and lemon water on cough, sore throat, and hoarseness after extubation of endotracheal tube following surgery.

A clinical trial was carried out in 110 patients undergoing surgery in Neyshabur 22 Bahman Hospital, Iran 2020. They were selected using convenience sampling and randomly allocated to experimental or control group. In experimental group, 6 hours after surgery, 30 cc of honey lemon water was gargled, three times, every two hours and then swallowed. The control group received routine care. Postoperative sore throat, cough, and hoarseness were assessed before the intervention, and 12 and 24 hours after extubation of endotracheal tube. Data were analyzed by independent t-test and repeated measures analysis of variance.

Findings showed no significant difference between the two groups in cough and sore throat 12 hours after extubation, but the score for hoarseness was lower in experimental group (P= 0.05). Twenty-four hours after extubation, cough (P= 0.001), hoarseness (P= 0.006), and sore throat (P= 0.023) were significantly lower in experimental group. The passage of time was found to significantly affect all three variables (P<0.001).

Considering the positive effects of gargling with honey and lemon water in reducing the complications of endotracheal tube and no side effects, it is recommended to be used after extubation.

Stigma and burden of care in caregivers of patients with schizophrenia have negative effects on the patient and their families. This research aimed to determine the effect of self-care training based on Acceptance and Commitment Therapy (ACT) on perceived stigma and caregiver burden of schizophrenic patients.

This randomized clinical trial included 80 caregivers of schizophrenia patients in Sari Zare Hospital. Participants in intervention group received self-care training based on ACT in 8 sessions twice a week, while the control group received only routine care. The scores for stigma and care burden were measured in both groups before and after the intervention using Shamsaei stigma questionnaire and Zarit Burden Interview (ZBI, 22-item). T-test and paired t-test and descriptive statistical methods were used to analyze the data.

The mean changes of the total score for perceived stigma before and after the intervention were found to be significantly different between the intervention group (65.45±6.79) and the control group (80.25±10.34)(P<0.05). Also, intergroup comparison showed a significant difference in mean changes of the total scores for burden of care before and after the intervention between the intervention group (44.35 ± 6.37) and the control group (55.05 ±10.29) (P <0.05).

According to current study, self-care training based on Acceptance and Commitment Therapy will improve perceived stigma and reduce burden of care in caregivers of patients with schizophrenia and such non-invasive interventions are recommended.

Sambucus Ebulus plant is known for its anti-inflammatory and wound healing properties. This study aimed to determine the effect of Sambucus Ebulus Gel 5% on the severity and surface area of pruritus in hemodialysis patients.

A single-blind randomized clinical trial was performed in 150 hemodialysis patients in three groups. We used Detailed Pruritus Score Introduced by Duo (1978) three times. The scale covers areas such as pruritus severity, distribution, frequency (morning and evening), and sleep disturbance. ANOVA test was used to compare the severity of pruritus between the three groups and Repeated Measure was used in each group.

The mean itching score at the beginning of the study was not statistically significant in all groups (P= 0.49), but at weeks four and eight after treatment significant differences were seen between the three groups in mean score for pruritus severity (P=0.03 and P= 0.01, respectively). Acacia gel and placebo reduced the severity of itching (P= 0.00) but in control group no significant changes occurred (P= 0.158). Findings showed significant improvements in dry skin condition among the intervention and placebo groups (P= 0.00).

According to current study, Sambucus Ebulus Gel 5% can be considered as one of the topical treatments to relieve and improve uremic pruritus and dry skin in hemodialysis patients.

The spread of COVID-19 can cause anxiety and depression and lead to adverse outcomes in perinatal period. This study aimed to evaluate anxiety and depression symptoms and associated factors in pregnant and breast feeding women during the COVID-19 pandemic.

This cross-sectional study included 450 pregnant and breast feeding women in Rasht, Iran during the second and third wave of COVID-19 (June-November 2020). Data were collected using convenience and multi-stage sampling in a teaching hospital and six healthcare centers. Anxiety and depression were evaluated by Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9, respectively. Descriptive statistics and analytical statistics, including independent t-test, Chi-square test, and logistic regression were used to analyze the data.

Generalized anxiety was seen in 16.9% of pregnant women and 10.7% of breast feeding women (P=0.057). Expectant mothers were 6.64 times more likely to have depressive symptoms compared with breast feeding women (ORAdj=6.64, 95% CI: 2.08-21.15). Comorbid anxiety-depressive symptoms were higher in pregnant women than breast feeding women (6.2% vs. 0.9%, P=0.002). Anxiety was found to be significantly associated with an unemployed husband, having chronic diseases, thinking about COVID-19, and high-risk individuals in the family (P<0.05). Also, there was a significant relationship between depression and pregnancy, less educated husband, and high-risk individuals in the family (P< 0.05).

In this study, pregnant and breast feeding women showed more anxiety symptoms than depression symptoms during COVID-19. Expectant mothers were more likely to have depressive symptoms than breast feeding women. These results emphasize the importance of mental health monitoring to improve perinatal-care quality during epidemics/social crises.

Caring for patients with COVID-19 at home is mainly the responsibility of the family which leads to high burden of care. The burden of care refers to psychological pain, physical problems, financial and social pressures, disruption of family relationships, feelings of hopelessness, and other negative consequences of care tasks. The aim of this study was to determine the care burden in caregivers of patients with COVID-19 at home.

This cross-sectional descriptive-analytical study was carried out in 390 family caregivers of patients with COVID-19 attending medical centers in Gorgan, Iran 2021, using convenience sampling. Caregiver Burden Inventory (CBI) was administered which consists of five domains and a score range of 24-120. Data were analyzed in SPSS V18 applying equivalent non-parametric tests.

The mean total score for care burden was 52.70±17.03 and the mean scores for other subscales were as follows: 14.90±6.22 for time dependence=, 10.80±4.88 for developmental, 9.60±4.36 for physical burden, 7.80±2.91 for social burden, and 9.60±3.84 for emotional burden. As the age of the caregivers increase, the burden of time dependence increased. Women and caregivers with low educational backgrounds perceived a higher burden of care. There was a significant relationship between the burden of care and patient's economic status and the health status of the caregiver (P<0.05).

Family caregivers of patients with COVID-19 at home received a moderate burden of care that could negatively affect their health and wellbeing. Family caregivers need to be supported psychosocially and financially by formal community health systems.

Timely diagnosis of patients with suspected COVID-19 using chest Computed tomography (CT) scan is of great benefit in reducing the severity of the disease. Previous studies did not address this issue, so, this study aimed to investigate the findings of chest CT scan images and the severity of lung involvement in patients hospitalized with COVID-19.

We performed a retrospective descriptive-analytical study in all patients admitted to Qaemshahr Razi Hospital with symptoms of COVID-19 and positive RT-PCR test results in 2019-2020. All chest scans were reviewed and reported by a radiologist. Data were analyzed using Chi-square and t-test.

The patients (n= 666) included 51.36% women and 48.64% men. The mean age of patients was 54.06±16.55 years. Moderate lung involvement was more common and ground-glass opacity (GGO) was the highest encountered pattern (39.33%). Also, in severe lung involvement, GGO pattern was found to be more prevalent (22.37%). Minimal lung involvement (0-25%), moderate lung involvement (25-50%), and sever lung involvement (> 75%) were seen in 6.75%, 22.29%, and 20.27%, respectively. Most of the patients were highly suggestive of COVID-19 and moderate lung involvement (45.97%) was found to be higher in this condition. No significant difference was seen between the extent of lung involvement in patients studied (P= 0.535).

The CT scan results in our patients in Mazandaran province with COVID-19 showed primarily GGO followed by consolidation and crazy paving patterns.

Recently, due to the reduction of hepatitis A in Iran there are people with low or no Hepatitis A Virus- Antibody (HAV-Ab), therefore, people at Arbaeen Pilgrimage are at risk for hepatitis A. This study aimed at examining HAV-Ab in pilgrims traveling from Mazandaran province, Iran to Karbala in 2018.

This cross-sectional study was performed in 200 people selected from 40,000 pilgrims in Mazandaran province. Serum samples were evaluated for presence of HAV-Ab and data for demographic characteristics and history of hepatitis A immunity were recorded. Data analysis was performed in SPSS V16.

The participants were 137 (68.5%) males and 63 (31.5%) females. Positive and negative HAV-Ab were seen in 156 (78%) and 44 (22%), respectively. Mean ages of people with positive and negative HAV-Ab were almost similar (50 years and 47 years, respectively). HAV-Ab status was found to be significantly associated with job (P<0.05) but it was independent of gender, level of education, area of residence, history of hepatitis A vaccination, previous history of hepatitis A infection, known underlying diseases, and history of travel to endemic areas (P>0.05).

Twenty-two percent of people who were travelling to Karbala had no HAV-Ab, which is significant because the risk of developing fulminant hepatitis increases in adults, therefore, vaccination of Karbala pilgrims for hepatitis A virus is suggested.

Determining the occlusal plane is one of the essential clinical steps in prosthetic treatment. Intraoral landmark of parotid papilla is used as an adjunct in determining the occlusal plan. The aim of this study was to investigate the exact distance between the parotid papilla and the occlusal plane as an additional criterion for determining the occlusal plane.

In this cross-sectional study, the study group consisted of 148 patients aged 18-50 years old including 74 men attending Sari Dental School in 2019. In maximum intercuspation, vertical distance from the parotid papilla site to the occlusal surface of the first molars of the maxilla was measured by a probe. Data analysis was performed applying Mann-Whitney and correlation test.

The mean distance (mm) between the parotid papilla and the occlusal plane for the right papilla (R) was 6.16, while for the left papilla (L) it was 6.51 (R=6.47 and L=6.70 in men and R=5.84 and L=6.31 in women).  The distance at both the right and left sides was higher in men (P= 0.009 and P= 0.044, respectively). Significant difference was seen between both sides in the distance which was higher at left side (P= 0.03). Findings showed no significant relationship between age and this distance at right (P= 0.083) and left (P=0.065) sides.

The amount of parotid papilla distance to the occlusal plane on both sides was significantly higher in men than that in women. Also, this distance on the left side is significantly higher than the right side. There was no significant relationship between age and the distance stusdied.

Some measurements such as angles and planes drawn in lateral cephalometry have different relationships and correlation coefficients which help to distinguish different types of malocclusions. The aim of this study was to investigate the correlation between ANB, Wits, occlusal plane, and Y-axis cephalometric measurements in patients with class II malocclusion.

A descriptive-analytical and retrospective cross-sectional study was performed using the lateral radiographic images (n=156) in the archive of the Dental Clinic affiliated with Golestan University of Medical Sciences obtained from patients aged 14-18 years of age with class II malocclusion in 2018-2019.

There were 91 (58.3%) lateral radiographic images of female patients, and 65 (41.7%) of male patients. The highest correlation was found between ANB and Wits measurements (r= 0.61) followed by ANB and Y-axis (r= 0.53), Wits and occlusal plane (r= 0.36), and Y-axis and occlusal plane (r= 0.33) and the lowest correlation was seen between ANB and occlusal plane measurements (r= 0.23).

According to current study, it seems that in addition to ANB angle, other cephalometric measurements such as Wits, Y-axis, and occlusal plane can be used to diagnose class II malocclusion (based on their correlation coefficient with ANB).

Microbial electro-Fenton system as a novel technology can be employed in removal of resistant organic pollutants along with generation of renewable electrical energy through the activity of anaerobic microorganisms. This study aimed at investigating the performance of this process in treatment of synthetic wastewater containing tetracycline and generation of electricity in different electrical circuit conditions.

In this experimental study, a two-chambered microbial electro-Fenton reactor equipped with anodic and cathodic carbon felt electrodes and Nafion membrane, along with 2000 mg/L substrate and anaerobic sludge as inoculum in anodic chamber and 10 mg/L tetracycline in cathodic chamber was used in open, closed, and short circuit conditions. The effect of electrical circuit type on the removal efficiency of tetracycline and generation of electrical energy was investigated during the operation of the reactor.

Microbial electro-Fenton system was found to be more efficient in removal of tetracycline in short circuit condition due to improved generation of current density. In this study, 260 mV and 93.13 mW/m2 in current density of 695 mA/m2 were obtained in short circuit conditions.

The study showed that the microbial electro-Fenton system can be utilized as a suitable method in removal of various pharmaceutical contaminants from wastewater while producing renewable and clean energy in open, closed, and short electrical circuits.

Major histocompatibility antigens are the most polymorphic components of the immune system. The purpose of this study was to determine the frequency of human leukocyte antigens (HLA) in a population in Mazandaran province, Iran.

In a cross sectional study, peripheral blood samples were obtained from 550 people in Immunogenetics Research Center affiliated with Mazandaran University of Medical Sciences, 2016-2021. The types of HLA class 1 antigens (A-B-C) were studied using SSP-PCR.

HLA-A * 24, HLA-B * 35 and HLA-C * 04 were found to be the most common alleles in the population studied.

HLA diversity plays a major role in developing some diseases. So, it should be investigated in anthropological studies and finding a suitable donor in bone marrow transplantation. In fact, more extensive studies are required to draw a new horizon in the association between HLA and diseases in different ethnicities.

Bone cement implantation syndrome is an important factor in changing the hemodynamic status of patients during orthopedic surgery. Anesthesiology team and surgeons should be aware of these hemodynamic changes and prevent complications, so, the aim of this study was to investigate the hemodynamic changes in patients during the use of bone cement.

This descriptive-analytical study was performed in orthopedic surgery patients in Tehran Baqiyatallah Hospital, Iran 2021. The patients had no pathological diseases and bone cement was used in their surgery.

The participants (n=63) included 50 (79.36%) males. The mean age was 43.63±4.60 years, the weight was 79.31±9.1 kg, and the mean systolic blood pressure levels 30 minutes before and during surgery were 128.79±4.83 mmhg and 119.50±7.32 mmhg, respectively. Half an hour after bone cement implantation, it was 121±4.79. Mean diastolic blood pressure levels were 78.12±5.23 mmHg and 74.26±4.58 mmHg half an hour before surgery and during surgery, respectively and 74.71±6.54 mmHg half an hour after bone cement application. Mean heart rate changes were 76.41±5.84 half an hour before surgery, 80.77±7.71 during cementation, and 78.49±6.53 half an hour after cementation. Mean blood oxygen saturation before and during the operation were 97.03%±1.14 mmHg and 93.57%±1.98 mmHg, respectively and 94.0% ± 2.36 mmHg half an hour after bone cement implantation.

Current study showed that bone cement implantation decreases systolic and diastolic blood pressure values and arterial blood oxygen saturation but increases heart rate. However, the hemodynamic status would be normal by half an hour after bone cement implantation.

Treatment of rheumatic diseases depends on proper use of medications. The aim of this study was to evaluate the frequency and reasons for discontinuation of drugs in these patients.

A cross-sectional study was performed in patients with inflammatory rheumatic diseases in Sari, Iran 2020-2021 to investigate the frequency and reasons for discontinuation of drugs. Statistical analysis was performed using SPSS V20 and descriptive statistical methods were used to determine the frequency of drug discontinuation and its causes.

The participants (n=251) included 197 patients with rheumatoid arthritis, 31 with systemic lupus, 16 with ankylosing spondylitis, and 7 patients with psoriatic arthritis. The mean age of patients was 52.36±13.4 and mean duration of illness was 8.35±7.31 years. Drug discontinuation was seen in 73 patients (85 cases). The most common reason for drug discontinuation was drug side effects (55.4%). Drug shortage, transient improvement of symptoms, ineffectiveness of the drug, and fear of developing COVID 19 were some of the reasons for discontinuation of drug.

The most common cause of discontinuation of treatment was drug side effects, but in about one third of cases, there are factors that could be corrected to help preventing drug discontinuation and non-adherence to treatment.

Systemic conditions, such as diabetes or cardiovascular disease are associated with periodontal disease. Recent studies suggested a link between periodontitis and gastrointestinal cancers. Due to the importance of this issue, this study aimed to evaluate the prevalence of chronic periodontitis in patients suffering from gastric, esophageal, and colorectal cancers attending Sari Imam Khomeini Hospital, 2017-2018.

In this cross-sectional study, clinical examination of 100 patients was performed by assessing clinical attachment loss (CAL), bleeding on probing (BOP), and tooth loss. After recording the periodontal pockets' depth and gingival recession, the CAL was calculated. Chronic periodontitis was categorized as mild, moderate, and severe based on classification of periodontal disease. Chi-Square and ANOVA were applied for data analysis.

According to findings in patients with gastric cancer (n= 23) mild, moderate and sever periodontitis were seen in 8.7%, 26.1%, and 26.1%, respectively. There were 10 patients with esophageal cancer of whom 40% were healthy, 40% had moderate periodontitis, and 20% had severe periodontitis. Among patients with colorectal cancer (n=67), 7.5% had mild periodontitis, 46.3% had moderate periodontitis, and 1.5% had severe periodontitis.

In patients with moderate to severe chronic periodontitis, due to the loss of periodontal support of the teeth that leads to loosening the teeth, the chances of tooth loss increase which naturally disrupts the patient's eating process and causes digestive problems.

Single superficial femoral artery (SFA) aneurysm is rare and occurs in approximately 5 per 100,000 patients. Rupture is a rare complication in this aneurysm. In this case report, we present the diagnostic and therapeutic work up of a ruptured SFA aneurysm of the right lower limb in a 75-year-old diabetic man with ischemic heart disease. Pre-surgical diagnosis was through physical examination findings and color Doppler flow imaging. The defective part of the artery was resected and then reconstructed through autologous saphenous vein grafting harvested from the opposite limb. No early post-surgical complication was observed. If a pulsatile mass is found in the thigh, the SFA aneurysm should be considered as a differential diagnosis to prevent premature death and lower limb amputation by timely surgery.

This meta-analysis review aimed to investigate the effect of resistance training on functional performance and physiological factors in patients with ischemic stroke.

The search was conducted in PubMed, Web of Science, and Scopus using related keywords. All articles were reviewed, but 22 studies that met the inclusion criteria were included after screening.

Based on findings, resistance training had a significant effect on the Six-minute Walk Test (difference in means= -32.04, P= 0.028), the Berg Balance Scale (difference in means= -2.37, P= 0.018), handgrip strength test (Difference in means= -2.05, P= 0.001), and Gait Speed (difference in means= -0.089, P= 0.101) in patients with ischemic stroke. However, resistance training did not significantly affect the Up and Go Test (difference in means= -2.27, P= 0.192) in these patients. On the other hand, according to several physiological indicators in different subgroups, including body mass index, TC, HDL-C, and LDL-C, resistance training did not have a significant effect (difference in means= 0.02, P= 0.642) in patients with ischemic stroke.

Resistance training improves the performance of patients with ischemic stroke. This improvement occurs in both the upper and lower body, but resistance training did not improve physiological parameters in ischemic stroke patients.

Transverse problems in the maxilla (high arched- narrow hard plates) can cause respiratory disorders. Palatal expansion can be helpful in this way. The present study aimed at evaluating the effect of bone borne expansion and tooth borne palatal expansion on airway volume.

A review study was performed by search in Google Scholar, Scopus, PubMed, Embase, and Cochrane using the following keywords: maxillary expansion, palatal expansion, miniscrew-assisted palatal expansion, tooth borne, bone borne, rapid palatal expansion, airway dimension, and Cone beam computed tomography. The search was limited to articles published in January 2011-April 2021.

In the initial search, 343 articles were found. After reviewing the titles and abstracts only 20 papers were found that studied the effect of bone and tooth borne palatal expansion on airway dimensions and met the inclusion criteria. The studies indicated that both bone expansion and tooth borne palatal expansion could considerably increase airway volumes. However, only bone borne palatal expansion enabled more predictable and greater skeletal expansion and less teeth response.

Both bone and tooth borne palatal expansion are efficient in increasing the airway volume. Further randomized clinical trials with large sample size and matched control groups, longer follow-up periods and measuring respiration index such as apnea-hypopnea index are suggested.

In recent decades, empowerment of managers has become one of the main concerns of organizations. High workload, working conditions and competitiveness of organizations reveal the need for empowering managers. There are no comprehensive model or theory in that regard. The purpose of this study was to systematically review and identify the dimensions and components of empowerment of managers.

This study was done using a meta-synthesis approach. Systematic review of library studies and articles published in national and international scientific databases, including Migrants, Civilica, Noormags Emerald, ProCost, Science Direct, Google Scholar, Elment, Otad, and Sage (1977-2020) were searched to identify the components of empowerment of managers.

In literature, empowerment of managers is defined according to three concepts; comprehensive empowerment, constructive empowerment, and basic empowerment. Comprehensive empowerment includes psychological and structural empowerments. Comprehensive psychological empowerment consists of psychological components, job components, and personality traits.  Structural empowerment includes organizational components and educational and learning components. It should be noted that all these components have their primary themes.

All organizations are needed to carefully examine managers’ empowerment and benefit from the maximum power and capacity of managers’ talents by recognizing their strengths and weaknesses.