مجله دانشگاه علوم پزشکی مازندران
پیاپی 221 (خرداد 1402)

Acute liver failure is caused by several factors including drugs. Isoniazid, which is used as an effective drug in treatment of tuberculosis, is considered a strong toxic agent for the liver. The purpose of this study was to investigate the effects of cinnamon extract on isoniazid-induced hepatotoxicity in rats.

In this experimental study, 60 male Wistar rats were randomly divided into six groups. Liver damage and oxidative stress were induced by administration of isoniazid (300 mg/kg/day) for 14 consecutive days. Different doses of cinnamon extract (50, 100, and 200 mg/kg) were administered by gavage. Liver damage caused by isoniazid was evaluated by examining serum biochemical factors, amount of reactive oxygen species, glutathione, antioxidant capacity, lipid peroxidation, and histopathological changes in liver tissue. Data analysis was performed in Prism software applying one-way analysis of variance (ANOVA) and Tukey's post hoc test.

Isoniazid at 200 mg/kg caused liver damage and significantly increased liver damage biomarkers (biochemical biomarkers, oxidative stress indices, and histopathological changes) (P<0.05). On the other hand, different doses of cinnamon extract significantly reduced the biomarkers of liver damage caused by isoniazid (P<0.05) and also improved the histopathological changes of liver tissue.

Cinnamon extract with antioxidant properties protects the liver against oxidative damage caused by isoniazid.

Cardiovascular diseases (CVDs) are the leading cause of death worldwide that account for 82% of all deaths in developing countries. miRNA-93 (miR-93), ATP-binding cassette transporter A1 (ABCA1), and serum leptin levels may be involved in the process of atherosclerosis. The aim of this study was to investigate the effects of combined exercise on miR-93, reverse cholesterol transport (RCT) and serum leptin levels in patients following coronary artery bypass graft surgery (CABG).

A total of 20 middle-aged men (aged 50 to 60 years) were randomly assigned into two groups after CABG: experimental (n=10) and control (n=10). Combined exercise (aerobic + resistance) was done three times a week (55-60 min per session/8 weeks). mir-93, ABCA1 and serum leptin levels were measured before and after the intervention. Paired t-test was used to evaluate within group changes and analysis of covariance was used to study the differences between the groups.

Combined training led to a significant decrease in mir-93 (P=0.000) and a significant increase in the expression of ABCA1 (P=0.001) in experimental group compared with the control group. Serum leptin levels decreased significantly in experimental group (P=0.000) but they were not significantly different between the two groups (P=0.094).

It seems that combined exercise by increasing ABCA1and decreasing mir-93 and leptin levels can help in prevention and control of CAD as well as speeding up the healing process in CABG patients.

Oral diseases are the most common health problems in cancer patients, influencing their quality of life. This study aimed to evaluate the effect of education on oral and dental health behaviour based on the Pender health promotion model in cancer patients..

This semi-experimental study was conducted in 40 adult cancer patients attending Notovan Physiotherapy and Lymphedema Center in Mashhad, Iran, 2019. The samples were selected by systematic random sampling. The educational intervention based on the Pender health promotion model was delivered in six theoretical and practical training sessions, with a one-week interval between the sessions. Data were collected using a standard questionnaire based on the components of the Pender health promotion model that was completed before the intervention, immediately, and two months after the intervention. Data analysis was done in SPSS V22, applying descriptive tests and repeated measures ANOVA.

Findings showed significant differences in the score for behaviour before the intervention (25.82±4.57), after the intervention (32.41±4.24), and two months later (29.79±3.72) (P<0.001). In addition, after the intervention, among different components of the Pender health promotion model, self-efficacy, positive emotions, and interpersonal influencing factors increased significantly (P<0.001). At the same time, perceived barriers decreased significantly (P<0.001).

The current study supports the positive effect of the Pender health promotion model in enhancing oral and dental health behaviour in adult patients with cancer.

Today, coronary artery disease (CVD) is one of the world's most common disorders, and prevention is the key to controlling the disease. The present study aims to determine the effectiveness of emotionally focused couple therapy (EFCT) on attachment behavior and marital intimacy in patients with CVD.

A semi-experimental study with pre-test, post-test, and follow-up design was conducted in 34 couples, that one of the partners had CVD, in Mashhad, Iran 2022. Those who met the inclusion criteria were randomly assigned into an intervention group (n=16 couples) or a control group (n=18 couples) using Permuted block randomization. An emotionally focused couple therapy based on the Healing Hearts Together (HHT) educational program was performed in the intervention group during eight weekly, 2-hour sessions. The control group received only routine care. Data were collected using the Brief Accessibility, Responsiveness and Engagement Scale (BAER) and the marital intimacy needs questionnaire (MINQ) before, after, and two months after the intervention. Data were analyzed using Chi-square, independent t-test, and repeated measures ANOVA.

In the intervention group, the pre-test, post-test and follow-up mean scores for the attachment behavior (45.62±5.89, 53.81±3.10, and 50.87±2.44, respectively), and the components of emotional intimacy (37.56±5.22, 41.75±2.93, and 39.93±2.20, respectively), psychological intimacy (32.43±2.36, 37.25±2.86, and 36.50±4.06, respectively), rational intimacy (34.68±5.68, 36.75±2.90, and 36.37±2.87, respectively), sexual intimacy (32.18±4.38, 37.01±4.44, and 39.06±4.69, respectively), and physical intimacy (33.87±4.58, 38.25±3.51, and 39.37±3.98, respectively) showed significant increase at post-test and follow-up (P<0.04) , but there were no significant differences between the scores in the control group (P>0.05).

Emotionally focused couple therapy based on the Healing Hearts Together (HHT) educational program can improve attachment behavior, and marital intimacy in patients with coronary artery disease.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder associated with problems in social interaction. The aim of this study was to compare the effectiveness of puppet psychodrama and pantomime on social interaction in children with ASD.

We performed a quasi-experimental study in 7-11 year-old children (n=45) with high functioning ASD. They were selected from the Welfare Centers of Tehran, Isfahan, Guilan, and Mashhad Provinces in 2020-2021 school year using convenience sampling. The participants were assigned into two experimental groups (puppet psychodrama or pantomime) and one control group (n=15 per group). The two experimental groups separately participated in 20 virtual sessions (twice a week; 15 minutes per session) and received puppet psychodrama or pantomime, while the control group only participated in mainstream programs of the Center. The social interaction of all participants were evaluated using the Autism Social Skills Profile before and after the intervention and after eight weeks. Descriptive indices were used and Chi-square, Shapiro-Wilk test, Mauchly’s sphericity test, and the Repeated measures ANOVA were applied for data analysis.

The eta-quotients showed that both puppet psychodrama and pantomime significantly changed social interaction (88% and 78%, respectively) and its components, including social reciprocity (88% and 78%, respectively), social participation (89% and 81%, respectively), and detrimental social behavior (87% and 76%, respectively) (both P<0.001). The puppet psychodrama compared to pantomime led to 37% of variation in social interaction. The findings indicated that the control group did not change significantly over time (P>0.05).

Considering the effectiveness of puppet psychodrama, it can be used as an alternative method along with other family-oriented interventions and prevent the consequences of social interaction problems.

Biopsy is the standard criterion for the diagnosis of liver fibrosis, but it is not widely used for liver fibrosis monitoring due to its invasive nature, risk of complications, and sampling errors. This study aimed to evaluate the clinical significance of several noninvasive indices in diagnosis of the disease and in prediction of advanced liver fibrosis in children with autoimmune hepatitis (AIH).

In a prospective cross-sectional study, in 40 children with AIH, complete blood count and liver function tests were performed and their derived indices were calculated. Based on liver biopsy, all patients with AIH were divided into two groups: absent/mild fibrosis and moderate/severe fibrosis (advanced fibrosis).

In patients with AIH, aspartate aminotransferase to platelet ratio index (APRI) and fibrosis index based on four factors (FIB-4) increased significantly (P<0.001) and neutrophil to lymphocyte ratio index (NLR) decreased significantly (P=0.041) compared to healthy individuals. In patients with advanced fibrosis, direct bilirubin (DBIL) and APRI levels were considerably higher and albumin levels were considerably lower compared to the absent/mild fibrosis group. Analysis of the area under the receiver operating characteristic curve (AUC) showed that FIB-4 and APRI have clinical value for the diagnosis of AIH in children while DBIL and APRI had clinical value in diagnosis of advanced liver fibrosis in these children.

APRI can be used as a reference index in diagnosis of AIH in children and to monitor liver fibrosis in children with autoimmune hepatitis.

The SARS-CoV-2 can increase blood levels of D-dimer by causing thrombosis and affecting the homeostasis system. This study aimed at investigating the blood levels of D-Dimer and its relationship with the incidence of headache in patients with type 2 diabetes infected with COVID-19 who were admitted to Ilam Shahid Mostafa Hospital, Iran.

We studied the patients hospitalized in Ilam Shahid Mostafa Hospital. with COVID-19 (n=988) in two groups of with and without diabetes. Blood levels of D-dimer, and glucose, and also the incidence of headache were evaluated in all patients.

Fasting blood sugar levels, blood levels of D-dimer, white blood cell count, and ESR significantly increased in diabetic patients with COVID-19 compared with the non-diabetic patients (P<0.001). The incidence of headache was found to be significantly lower in diabetic patients than non-diabetic patients (n= 91, P= 0.0009).

According to present research, there is an inverse relationship between the blood levels of D-dimer and incidence of headache in diabetic people with COVID-19, as by increase in blood levels of D-dimer the incidence of headache decreased.

The tensions in the emergency department can affect job satisfaction and professional values of nurses working in this department which may influence their clinical performance. The present study investigated the performance of emergency department nurses during cardiopulmonary resuscitation (CPR) and its association with professional value and job satisfaction.

This cross-sectional study was conducted in 10 hospitals affiliated to Mazandaran University of Medical Sciences in 2020-2021. The study samples were 258 nurses in emergency department selected via convenience sampling and quota based on the number of emergency department personnel in every hospital. Data were collected using demographic questionnaire, self-performance checklist in CPR, The Minnesota Satisfaction Questionnaire (MSQ), and The Nurses Professional Values Scale--Revised (NPVS-R). Data analysis was carried out in SPSS V22.

The majority of samples (71.7%) were women and the mean age of participants was 31.09±4.7 years. The overall mean scores for professional value, job satisfaction, and nurses' self-performance in CPR were 100.49±14.7, 56.34±12.7, and 30.84±3.0, respectively. Weak direct correlation coefficients were found between nurses' job satisfaction and their performance (r=0.201, P=0.001) and professional values (r=0.339, P=0.001), and also between their professional values and performance (r=0.374, P=0.001).

In this study, direct relationships were found between the performance of emergency department nurses in CPR and professional values and job satisfaction. Measures should be taken so that nurses get more familiar with different dimensions of nursing professional values and internalize these values in a wide range of nursing affairs, thereby having higher job satisfaction and clinical performance.

The frequency of traffic accidents is in a critical situation in Iran. This epidemiologic survey aimed at evaluating traffic accident injuries in emergency department at Gorgan 5Azar Hospital.

In this retrospective, cross-sectional descriptive study, the population included all patients who were admitted to the emergency department at Gorgan 5Azar Hospital (The Trauma Center in Golestan Province), 2019-2020 due to road accidents. Data were recorded in a checklist and analyzed in SPSS V20.

There were 1042 people that injured by road accidents with the mean age of 29.7±16.01 years. The patients were 80.1% men. Most of the accidents occurred during the day (63.2%) at summer (29.7%) in August (10.7%). Road accidents were more frequent in rural roads (63.1%) and among vehicle drivers (63.1%) and mainly motorcycle drivers (47.4%). Out of all cases with road injuries 626 (60.1%) fully recovered and 12 cases (1.2%) deceased.

In this study, accidents were more frequent in suburban roads, especially rural roads, in men and young people. Traffic accidents are among the social issues that could be prevented. More attention should be paid to safety and compliance with standards in the construction of roads, especially in villages, as well as education of the youth population.

Elder abuse is one of the challenges in caring the seniors that can disrupt their general health. The goal of the current study was to determine the relationship between general health and elder abuse among older adults referring to health centers in Sari, Iran 2021.

A descriptive-analytical study was conducted in 347 older people who were selected by cluster random sampling. Data were collected using a demographic questionnaire, General Health Questionnaire–28 (GHQ-28), and Domestic Elder Abuse Questionnaire through interviews. Data analysis was carried out in SPSS V22 applying descriptive statistics, independent t-test, analysis of variance, multiple linear regression, and Pearson correlation coefficient.

In this study, the mean age of the older people was 72.86±8.62 years and 53.9% of the participants were men. The highest and lowest prevalence of abuse were associated with emotional neglect (72.9%) and ostracism (9.8%), respectively. According to findings, 57.3% of the older people had poor general health. Significant correlation coefficients were found between most of the components of general health and elder abuse, except between neglect and physical health (P=0.105), anxiety and insomnia (P=0.707), and social functioning (P=0.211) and also between financial abuse and physical health (P=0.156).

Considering the high rate of abuse of older adults and its adverse effect on general health, preventive programs are needed to increase awareness and educate the seniors.

Periodic diagnosis and follow-up of odontogenic and non-odontogenic cysts are necessary to prevent malignancies and their consequences and can be of great benefit to health systems. The present study aims to assess the prevalence of odontogenic and non-odontogenic cysts in patients attending Sari Bu Ali Hospital.

We reviewed the pathology records (2011-2020) of patients in Sari Bu Ali Hospital and odontogenic and non-odontogenic cysts and also demographic data such as gender, age and location of the lesions. The relationships between the type of cysts and sex, age, and location of the lesions were determined by using Chi-square and Fisher's exact test in SPSS V22.

Findings showed 115 cysts; 81 (70.4%) in men and 34 (29.9%) in women. Patients aged 30-44 years old (27.8%) attended the hospital more than other age groups. Odontogenic cysts and non-odontogenic cysts were seen in 97.4% and 2.6% of the cases. Non-odontogenic cysts were seen only in women, while odontogenic cysts were common in both men and women (100% and 91.2%, respectively). The sites with the highest prevalence of cysts in men and women were the mandible and maxilla, respectively.

According to the present study, the frequency of odontogenic cysts was higher than non-odontogenic cysts. Compared with other studies, the prevalence of non-odontogenic cysts was lower in this study and odontogenic cysts were mainly of inflammatory origin.

Hypoxia is a decrease in oxygen levels of body tissues which can lead to body function impairment. Coenzyme Q and folic acid are well-known drugs with distinctive antioxidant and anti-ischemic activities, but, nothing is known about antihypoxic activities of these compounds. The current study investigated the antihypoxic activities of Coenzyme Q and folic acid in three experimental models of hypoxia; asphyctic, circulatory, and hemic.

Protective effects of coenzyme Q at 25, 50, and 100 mg/kg and folic acid at 10, 20, and 40 mg/kg against hypoxia-induced lethality in mice were evaluated by increase in the survival time in asphyctic hypoxia, haemic hypoxia, and circulatory hypoxia models against negative control (normal saline) and positive control (propranolol 30 mg/kg). Analysis of variance was performed followed by Newman-Keuls multiple comparison test to determine the differences between means.

Coenzyme Q at 25 mg/kg, in asphyctic and circulating models, showed activities similar to those of propranolol in increasing the survival time (P>0.05). Folic acid at 10 mg/kg, in hemic and circulating models, exhibited activities similar to those of propranolol in increasing the survival time (P>0.05).

Coenzyme Q and folic acid showed good protective effects by increasing the survival time against hypoxia in all models. The effects were dominant, especially in asphyctic and circulating models for coenzyme Q and in hemic and circulating models for folic acid which led to prolonged survival times. These drugs seem to have a good potential in treatment of hypoxic conditions.

Recent studies suggest that HDL-C may not serve as a useful biomarker in the diagnosis of coronary artery disease (CAD). The present study aimed to improve the prediction of CAD in type 2 diabetes (T2D) patients with nephropathy by substituting the activity of paraoxonase 1 (PON1) for HDL-C.  

This study examined 48 T2D patients who underwent coronary angiographic examination. The subjects were divided into two groups: non-CAD and CAD. For measuring PON1 activity, the initial rate of substrate hydrolysis (phenylacetate) was spectrophotometrically assayed at 270 nm. Receiver operating characteristic (ROC) analyses were performed to compare the predictive performance of the study biomarkers.

The area under the ROC curve showed increases in the diagnostic performance of the study atherogenic ratios by replacing HDL-C with the PON1 in T2D patients with nephropathy. LDL-C/PON1 (AUC=0.72, P=0.048) and log (TG/PON1) (AUC=0.81, P=0.005) had higher predictive powers compared with LDL-C/HDL-C (AUC=0.56, P=0.276) and log (TG/HDL-C) (AUC=0.67, p=0.038) for CAD risk assessment.

The ratios of LDL-C/PON1 and log (TG/PON1) improve the prediction of CAD in T2D patients with nephropathy. Our findings support efforts to practically use HDL function instead of HDL-C levels for CAD diagnosis.

Lasers are of great importance in dentistry and have shown positive results in surface conditioning of ceramic brackets. The aim of this study was to compare the effect of two surface conditioning method, Nd:YAG laser and sandblasting on shear bind strength (SBS)  and (adhesive remnant index (ARI).

This experimental study was conducted in six groups of zirconia blocks to get prepared by laser (LG1-LG2-LG3) or sandblast (SG4-SG5-SG6). Two debonding methods, including conventional (LG3-SG3) and Nd:YAG laser (LG2-SG2) methods were used for zirconia blocks. SBS and ARI indices were compared between the two methods using ANOVA and post-hoc test.

The mean SBS did not show significant difference between LG1 and SG4 groups (8.2±2.04 and 7.1±1.5, respectively, P=0.228). ARI did not show significant difference between LG2 (3.1±0.8) and SG5 (3.5±0.7) groups (P=0.129) and between LG3 and SG6 (2.3±0.7 and 2.7±0.5, respectively, P=0.219). ARI was found to be significantly different between LG2 and LG3 (30.1±0.8 and 2.3±0.7, respectively, P =0.011) and between SG5 (3.5±0.7) and SG6 (2.7± 0.5) (P=0.024).

Nd:YAG laser can be considered a suitable alternative for zirconia surface conditioning and debonding ceramic brackets from zirconia crowns.

Removing cement-retained implant-supported crowns for repair or modification is one of the challenges in dental treatments. Using an access cavity in the crown to reach the abutment screw is one of the procedures proposed for recovering cement-retained dental implants. This study aimed to evaluate the retention rate of crowns having access cavity in a cemented-retained implants-supported prosthesis.

In this laboratory study, 60 casting metal crowns were created and separated into two groups (n=30 per group); with and without access cavity. The crowns were created using the Pro Dent 3D printer and the samples were linked to the universal testing equipment to analyze the retention rate after cementing with temp bond cement. Data were analyzed in SPSS V16 using the Kolmogorov-Smirnov test to determine the normality of data distribution and the t-test to compare the values between the two groups.

The mean retention in control group was 42.641±8.91.67 Newton, whereas it was 40.876±7.76333 Newton in crowns with access cavity. The rates were not significantly different between the two groups (P>0.05).

Preparing an access cavity in the crown has no effect on the retention of cement-retained implant-supported crowns. Therefore, cement-retained implant-supported crowns with retrievability characteristics can provide several benefits.

Asthma is a prevalent disease that affects oral health-related quality of life (OHQoL). There is no study on this issue in Iran, so this study investigated the OHQoL in asthmatic patients.

In this descriptive analytical study, 54 asthmatic patients in Sari Tuba Medical Center were examined. They were selected by convenience sampling. The Oral Health Impact Profile-14 (OHIP-14) was administered and Ramfjord teeth were selected to examine the OHI-S index. Data analysis was done applying descriptive statistics and Kolmogorov Smirnov test in SPSS V25.

The mean age of patients was 38.05±12.57 and 75.9% were women. The mean scores for OHIP-14 and OHI-S were 2.40±1.14. The highest score in the quality of life questionnaire was related to physical discomfort (1.17±0.96). There were no significant differences between gender, DI, and CI in OHQoL (P=0.893), and OHI-S and OHQoL (P=0.690).

In current study, no relationship was found between oral health of asthma patients and the OHQoL, but dentists are recommended to consider the impact of oral problems on patients' quality of life in addition to professional measures.

COVID-19 pandemic has affected different aspects of the health care system, including the outcomes of cardiac arrest. The purpose of this study was to compare out-of-hospital cardiac arrest (OHCA) during the first COVID-19 wave and the pre-COVID-19 time in Qom prehospital emergency care, Iran.

In a retrospective descriptive study, we compared the data of patients with OHCA who were registered in the Qom prehospital emergency care, during the first wave of COVID-19 (from 20 February to 3 April 2020) and the same period in 2018. The independent t-test was applied to analyze quantitative demographic data and Chi-square test was used to compare qualitative data and cardiopulmonary resuscitation (CPR) and its outcomes.

The incidence of OHCA was higher during COVID-19 pandemic than that in the same period in 2018 (248 cases vs. 189 cases). The incidence of cardiac arrest at home was also found to be significantly different between the two times (93.5% vs. 70.9%, P<0.001). The study also showed significant differences between the COVID-19 pandemic and the pre-COVID-19 period in the following parameters: return of spontaneous circulation (ROSC) (6.9% vs. 17.5%, P<0.001), endotracheal intubation (15.3%, vs. 34.4% P< 0.001), and defibrillation (18.5% vs. 43.4%, P< 0.001).

During the first COVID-19 wave in Qom, there were significant changes in the emergency responses to OHCA. Hence, emergency preparedness should be considered in possible future crisis.

Pain is one of the most common problems after hysterectomy which causes long-term complications in postoperative recovery or delayed recovery. Today, there is a lot of tendency toward complementary medicine, including massage, to reduce the side effects of drugs. The aim of this study was to determine the effect of foot massage on postoperative pain after hysterecxtomy.

A randomized controlled clinical trial was performed in 60 eligible hysterectomy patients. They were selected by convenience sampling at Tehran Shariati Hospital and Tehran Valiasr Hospital and divided into two groups using simple random allocation (n=30 per group) in 2017. In intervention group, foot massage was given for 20 minutes daily on two consecutive days after the operation, while the control group received routine care. Visual analog scale was used to measure pain intensity before the intervention and 24 hr after the intervention and also five days after the surgery. Data were analyzed by descriptive statistics, independent t-test, Chi-square, and Fisher's exact test.

We observed significant differences in the mean scores for pain intensity before the intervention and 24 hr after the intervention between the intervention group (2.01±0.41) and the control group (0.47±0.21) (P<0.001). But, this difference was not significant five days after the surgery (P=0.3).

Foot massage after hysterectomy is effective on reducing pain. This complementary method is easy and can be used as a low cost intervention along side other common treatments.

Considering the importance of internationalization in medical education, adaptation of successful international and national models can help to promote it. This study aimed at explaining the achievement of the universities of medical sciences in internationalization of medical education in Iran.

This descriptive-adaptive study was conducted in the international relations office at Kerman University of Medical Sciences (KMU). At first, top three universities in England, Pakistan, Ireland, Cyprus, and Greece were selected based on The Times Higher Education World University Rankings. According to the land-use planning classification in Iran, KMU is the university to follow and assess the performance of higher education in these countries. Then, information about the policies of these universities in internationalization of higher education was obtained using their websites or by request. We also collected information of KMU as a representative of eight universities of medical sciences and its affiliated academic and research centers.

Data about the ownership of universities, student recruitment strategies, and internationalization policies of the universities were compared with those of KMU and the weaknesses and strengths of KMU were determined.

The universities of medical sciences in Iran are suggested to revise their missions, goals, and performance and aim to practice internationalization of higher education as an important strategy in their university prospects.

The universal nature of science and increasing complexity of technological issues and developments in different sciences led to the growth of interdisciplinary cooperation. Some health issues such as addiction, population aging, emerging and re-emerging diseases, and environmental pollution are beyond the scope and capacity of a single-discipline expertise and require constructive dialogue and cooperation between different specialized fields. Currently in Iran, the development of interdisciplinary cooperation is not of much interest at medical sciences universities. The present policy brief aimed at addressing this issue by reviewing the upstream documents proposed by the Parliament Education/Research Commission, the development roadmap in the 9th and 10th governments, and interviewing elites in interdisciplinary fields.