مجله دانشگاه علوم پزشکی مازندران
پیاپی 222 (تیر 1402)

Endothelial progenitor cells (EPCs) and mesenchymal stem cells (MSCs) have useful effects in treatment of sepsis, but the effects of co-injection of EPC and MSC for the treatment of sepsis have not yet been investigated. This study investigated the therapeutic effect of MSC+EPC in reducing the systemic inflammatory response in lipopolysaccharide (LPS) induced sepsis in mice.

In this experimental study, mouse bone marrow MSCs and EPCs were isolated and their surface markers were investigated using flow cytometry. Four groups of mice (n= 12 per group) were included in the study. The control group had no treatment, group II received LPS intraperitoneally, group III received PBS buffer after LPS inoculation, and group IV received EPCs+MSCs after LPS inoculation. The serum and tissue levels of IL-1β, TNF-α, IL-6, and IL-10, and the serum levels of CRP and hepatic enzymes were determined by commercial kits. One-way ANOVA and post hoc test were used for comparison between groups.

The surface markers of MSCs and EPCs were confirmed by flow cytometry. The co-injection of MSC+EPC significantly decreased the levels of pro-inflammatory cytokines (P<0.001), increased the concentration of anti-inflammatory cytokines (P<0.001), and increased the survival rate (P<0.01). Mice treated with MSC+EPC represented a significant decrease in liver enzymes (P<0.05), pulmonary edema (P<0.01), and CRP level (P<0.05) compared to the mice with LPS-induced sepsis.

Co-injection of MSC and EPC leads to a reduction of the inflammatory response. This study provides promising results for the treatment of sepsis.

Radiation therapy is one of the most important methods in treatment of cancer. Targeted metal nanoparticles (NPs) play an effective role in reducing ionizing radiation side effects through increasing the effect of ionizing radiation on cancer cells and controlling the harmful effect of radiation on healthy cells. The purpose of this study was to investigate the effect of targeted folic acid gold NPs (GNPs) using linker bovine serum albumin in the absorption and sensitivity of gold NPs in HeLa cervical cancer cells compared to non-targeted gold NPs.

In this study, GNPs were conjugated with folic acid by bovine serum albumin as the linker. The binding of bovine serum albumin and folic acid to GNPs was investigated by infrared (IR) spectroscopy. Toxicity was measured by the MTT method and based on the results, the GNPs’ non-toxic concentration was determined. The effect of targeted synthesized GNPs on their absorption and sensitivity were evaluated on HeLa cells.

The non-toxic concentration of GNPs was 12 μg/ml. Incubation of the cells with this concentration was performed for 2, 4, and 24 hours and it was observed that in 4 hours, the absorption rate of targeted GNPs was about 4 times higher than that of non-targeted GNPs. The radiosensitization ratios of targeted and non-targeted GNPs in the studied cancer cells relative to the control group (without NPs) exposed to 6 MV photon radiation were 1.32±0.02 and 1.19±0.02, respectively.

The use of bovine serum albumin linker to target GNPs has a significant effect on increasing the absorption of GNPs and the effect of ionizing radiation on HeLa cells under 6 MV photon beams.

Gingivitis is an inflammatory disease of the gums caused by accumulation of dental plaque. It can become a chronic periodontal disease if plaque spread below the gum line. The most common pathogens that contribute to periodontal disease include Streptococcus mutans, Streptococcus pyogenes, and Candida albicans. Due to the side effects of common treatment by chlorhexidine mouthwash, novel treatments to fight such microbes are much of interest. This study aimed at comparing the antimicrobial effect of herbal mouthwash containing the extracts of nut-grass and thyme and chlorhexidine mouthwash on common periodontal pathogens.

First, Cyperus rotundus and Thymus vulgaris were collected, powdered, and the hydro alcoholic extract of the mixture of two plants and the methanol extract of each plant were taken. Then, a mouthwash containing combined extract of the two plants was prepared using different exipients. To evaluate the antimicrobial effect of the extracts, S. mutans, S. pyogenes, and C. albicans were used. After determining the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC), the effect of mouthwash on S. mutans biofilm formation and degradation was investigated.

The MIC of the mouthwash formulation against S. mutans, S. pyogenes, and C. albicans were 0.625, 0.039, and 2.5 mg/ml, respectively. The MBC of the mouthwash for each microorganism was 1.25, 0.078, and 10 mg/ml, respectively. The herbal mouthwash significantly inhibited biofilm formation compared to the positive control (P<0.05) which showed no significant difference compared to the negative control (P>0.05). Findings showed no significant difference in biofilm destruction between the herbal mouthwash and the positive control (P>0.05).

The prepared herbal mouthwash showed significant antimicrobial and anti-biofilm effects, and was much more effective in preventing biofilm formation than the standard treatment by chlorhexidine.

Leukemia is one of the most common and deadly diseases which is an important health problem. The aim of this study was to evaluate the survival of patients with acute lymphoblastic leukemia (ALL) and acute myeloblastic leukemia (AML) using the penalized splines model and comparing that with the Cox proportional hazards model.

This is a longitudinal survival research that used data from patients referred to Tehran Imam Khomeini Hospital between 2011 and 2014 and followed until 2016. Patients' information was collected through census, using a researcher-made checklist based on their files. Furthermore, the patients' latest status was obtained via phone calls. All medical records of the patients referred to Amir Al-Momenin hospital in Maragheh and diagnosed with prostate hyperplasia and underwent prostatectomy between 2014 and 2019 were examined taking a census. Kaplan-Meier nonparametric method was used to assess the 5-year survival rate, and Cox's semiparametric model was used to determine the risk factors in subgroups. Then, the penalized spline regression model was fitted using the R software version 4.2.2.

The average age of patients was 36.29±16.01 and 36.7% of the patients were men. Half of the patients died, and 12.7% experienced recurrence. Acute lymphoblastic leukemia affected 34.7% of the patients, whereas acute myeloblastic leukemia affected 63.3%. The 5-year-survival rates for patients with ALL and AML were 18% and 29%, respectively. Age, white blood cell count, platelet count, and hemoglobin levels were found to be significantly associated with patients' survival (P<0.05).

Leukemia is seen at young ages in Iran, so, early detection and treatment of the disease can play a critical role in improving the survival of patients.

Counseling services in Iran are required to understand the motivations for childbearing to provide better services. This study was conducted to investigate the confirmatory factor analysis of the Childbearing Questionnaire (CBQ) in Iranian men and women.

In this cross-sectional study, 398 married women of reproductive age (15-49 years of age) and 390 men, whose wives were at similar age were recruited. They were selected from Mashhad healthcare settings using multi-stage cluster sampling. The participants completed the CBQ. The reliability of the CBQ was assessed by test-retest and Cronbach's alpha. The validity of the scale was evaluated applying confirmatory factor analysis. SPSS V19 and Amos-21 were used for data analyses.

Cronbach's alpha coefficient and the test-retest reliability indicated satisfactory reliability of the CBQ in terms of positive childbearing motivation and negative childbearing motivation. The original model did not show acceptable fit. After removing eight factors with low loading and two correlated error terms, the modified model was found to have adequate fitness.

This study showed that some of the positive and negative motivations have changed due to cultural values of the Iranian society and are different compared with those of the western societies. This study supported the use of CBQ as a valid instrument in assessing childbearing motivations in Iran.

Poor sleep quality is one of the most common problems in older population. Sleep disorder has negative effects on physical, mental, and social aspects of their life and influences their quality of life.  This study was carried out to assess the sleep quality and its related factors in older adults.

This cross-sectional study was conducted in older adults aged 60 years and over living in Amol, north of Iran who were willing to participate in the study, did not have Alzheimer's disease and major depression, and could respond to questions. They were selected via multi-stage random sampling. The Pittsburgh Sleep Quality Index, Abbreviated Mental Test Score (AMTS), Hospital Anxiety and Depression Scale (HADS), SF36 Quality Of Life Questionnaire, and Physical Activity Scale For The Elderly (PASE) were used for data collection. A trained researcher filled out the research questionnaires.

Among 401 participants, 191 (47.6%) were women and 276 (68.8%) people were living in urban areas. Findings showed that 192 (47.9%) people had poor sleep quality. Multivariate logistic regression analysis showed significant relationships between sleep quality and taking sleeping drugs (adjusted OR: 6.57, 95% CI: 2.95-14.60, P=0.001), female gender (aOR: 5.40, 95% CI: 2.81-10.36, P=0.001), and depression (aOR: 0.46, 95% CI: 0.21-1.00, P=0.05), and also between physical (aOR: 0.97, 95% CI: 0.95-1.01, P=0.05) and mental (aOR: 0.95, 95% CI: 0.92-0.99, P=0.05) aspects of life.

Findings revealed a high prevalence of poor sleep quality in the elderly which was associated with female gender, taking sleeping drugs, and depression. So, appropriate interventions are suggested to improve sleep quality in older adults.

The diagnosis and treatment of cancer is stressful and perceived stress and concerns during the treatment period can add to this stress and affect the recovery of patients with gastrointestinal cancer. The aim of this study was to investigate the relationship between illness perception and coping styles, and perceived stress in patients with gastrointestinal cancer.

The present cross-sectional correlational study was conducted in 110 patients with gastrointestinal cancer in Sari Imam Khomeini Hospital, Iran 2022, selected by convenience sampling. Data were collected using a demographic questionnaire, The Brief Illness Perception Questionnaire (Brief IPQ), Billings and Moos Coping Styles Questionnaire, and Perceived Stress Scale (PSS). Finally, the data were analyzed applying descriptive statistics and Chi-square, independent t-test, Pearson's coefficient correlation, and ANOVA.

Most of the participants were females (50.9%), with a medium income level (59.1%), living in the city (91.8%), suffering from colon cancer (40.9%), and undergoing treatment (90.0%). Findings showed that most of the patients had a high level of perceived stress (57.3%), moderate levels of illness perception (71.8%), and moderate coping styles (71.8%). We observed an inverse relationship between perceived stress and illness perception (P<0.001, r=-0.604), but there were no significant relationships between perceived stress and coping styles (P=0.064, r=-0.177) and other demographic variables.

Considering the inverse relationship between illness perception and perceived stress, healthcare managers are suggested to take measures to improve the illness perception of patients with gastrointestinal cancer.

Upper gastrointestinal (GI) bleeding is one of the most common reasons for emergency admission. In majority of patients, bleeding stops spontaneously, but some high-risk patients may suffer from many complications secondary to upper GI bleeding, so differentiation of low-risk and high-risk patients in emergency departments is of particular importance. Glasgow Blatchford Score (GBS), Clinical Rockall Score (CRS) and Full Rockall Score (FRC) are the most common assessment tools for evaluating patients with upper GI bleeding.

In a prospective descriptive study, for 249 patients with upper GI bleeding who referred to an emergency department, GBS and CRS were used at first visit, and after endoscopy the FRC was used. Two weeks after discharge, a checklist was completed to determine the disease prognosis that included items about mortality, re-bleeding, the need for surgery, and blood transfusion.

In Glasgow Blatchford Scoring system, 238 (95.6%) people were considered high risk and 11 (4.4%) patients were low risk. CRS showed 165 (66.3%) high-risk patients and 84 (33.7%) low-risk patients. According to FRC, 193 (77.5%) patients were high risk and 56 (22.5%) were low risk.

The Full Rockall scoring system is an acceptable criterion for identifying high-risk patients and a very accurate post-endoscopic scoring tool that helps in identifying patients with a poor prognosis. Among the pre-endoscopic scoring systems, CRS is valuable in identifying low-risk patients, and their follow-up and endoscopy as an outpatient procedure. GBS is more valuable in identifying high risk patients.

Anatomical sciences are highly important in education of medical students due to their role in practice. Delivery of simple educational materials that are easily available to students have always been an interest of lecturers in this field. The present study aimed to compare the effect of blended teaching and traditional teaching on learning, memorization, and satisfaction of medical students in an embryology course in Amol medical Students, Iran.

In the present mixed method study, 50 medical students were randomly divided into two groups: educational film and control. Quantitative and qualitative evaluations were carried out. At quantitative level, midterm and final term exam results were studied and a standard checklist was used to measure satisfaction, etc. At qualitative level, information about students' views on educational videos was collected through interviews with 20 students and data were analyzed using qualitative content analysis.

According to quantitative data, the students in the intervention group showed significantly better results at both midterm and final exam compared to the control group (P<0.05). Also, the checklist analysis indicated the blended teaching was superior to traditional teaching and the scores of responses in intervention group were higher than the average. At qualitative analysis, effective learning was the main class extracted, which included three sub-classes of learning promotion, increasing motivation, and cognitive abilities.

Considering that this method does not cause disruption in education and can be effective in visualization courses such as embryology, it seems to be beneficial to students.

Borderline personality disorder is one of the most common disorders of mental health conditions. The aim of this study was to evaluate the effectiveness of transference-focused psychotherapy and acceptance and commitment treatment on neuroticism and impulsivity in individuals with borderline personality disorder.

In an applied quasi experimental study, we used single subject design involving ABA design in which a behavior is studied at baseline (A), during treatment (B), and after treatment (A). The statistical population included all patients with borderline personality disorder attending Sari Zare Psychiatric Hospital and Sari Mana Clinic in May to June 2020 (n=32). Eleven patients
were selected using convenience sampling and were randomly allocated to transference-focused psychoanalysis (n=4), acceptance and commitment-based therapy (n=4) or control group (n=3). Data were collected in five stages: baseline, mid-stage, progress stage, treatment termination stage, and follow-up for one year (100 sessions) using the NEO five-factor personality questionnaire and Barat impulsivity questionnaire. Data analysis was performed applying repeated measures and Kruskal-Wallis test.

In the repeated measurement test, a significant difference was seen in cognitive impulsivity between the two groups compared to the control group (P=0.025). According to Kruskal-Wallis test, transference-focused psychoanalysis was prioritized.

Considering that these two treatment methods do not aim to reduce symptoms, our final results showed that transference-focused psychoanalysis was more effective. But, further studies are need to generalize current findings.

As direct and continuous care providers to patients, nurses face various types of psychological stress in the work environment more than other groups. Meanwhile, moral distress in special care units is much more impressive. This study aimed to explain the moral distress experienced by nurses that provided care to patients with COVID-19 patients in special care units.

We performed a conventional qualitative content analysis in 2020-2021. The study population included nurses caring for COVID-19 patients in special care units selected by purposive sampling in educational hospitals affiliated with Mazandaran University of Medical Sciences. In-depth, semi-structured interviews were carried out for data collection. Graneheim and Lundman qualitative approach was used to analyze the data. The trustworthiness of the study was assessed by Guba and Lincoln's stringent criteria.

In this study, 14 nurses (25-48 yeas of age) were interviewed. We found three main layers and eight sub-layers, including multiple annoyances (mental and physical stress, negative effects on family and friends relationships, negative effects on professional work), work pressure (hard conditions of the patient and companion, difficulty and work stress, weak management), and persistence and adaptation (self-protection, coping with difficult conditions).

Based on this study, nurses should be encouraged to express their feelings so that they can establish a balance between the difficulty of ethical decisions and meeting the patient's needs and managing their emotions.

In Persian medicine, it is believed that the creation of life and its continuation depends on Innate Moisture, and natural human death occurs when this moisture ends. Despite the use of this term in medical texts, there is no acceptable understanding of this concept. The purpose of this research was to provide a systematic summary of data about Innate Moisture from the perspective of traditional physicians in different centuries, to explain that and enable more use of this concept in clinical setting.

The keywords in this study were as follows: Innate Moisture, Original Moisture, Moisture, al-Rotuba al-Ghrizia, al-Rotuba al-Asliyyah, Innate Humidity, and Natural Moisture in both Persian and English. We used Rodgers' evolutionary concept analysis which consists of a series of overlapping steps whose main goal is to clarify the concept.

In medical books, Moisture is considered from two perspectives: Moisture as an accident (quality) and Moisture as a substance (moist substance). Innate Moisture is present as a moist substance in the human body. The nature of Innate Moisture is less discussed in sources, but physicians are in agreement about its role as a main basis for the continuation of human life.

Innate Moisture can be divided into two types; original (originated from zygote) and non-original (originated from nutrition). Non-original Innate Moistures are considered as alternative for original Innate Moisture so that the original Innate Moisture is reduced less and remains as long as the natural life of the person continues.

Wound is a complication with high prevalence that negatively affects many people. The aim of this study was to evaluate the effects of Trigonella foenum-graceum L. and Convolvulus arvensis L. extracts on induced burn wounds in male Wistar rats.

Burn wounds were induced by hot plates burns under anesthesia. Twenty five rats were divided into five groups: normal saline, Eucerin, silver sulfadiazine, treatment groups treated with ointments containing 2.5% of Trigonella foenum-graceum L. or Convolvulus arvensis L. extracts. The wound area was measured at days 7, 14, 21, and 28, and 28 days after wound formation. Histopathological evaluation of the recovered tissue samples was done. Total flavonoids of the two extracts were determined. Microscopic analysis of wound healing was carried out and pathologic data were statistically evaluated.

In this study, wound size significantly decreased in rats treated with Convolvulus arvensis L. compared to Eucerin and normal saline groups. Furthermore, Trigonella foenum-graceum L. showed better efficacy than Eucerin. Pathological examination showed the highest improvements in the Trigonella foenum-graceum L. group and then in the Convolvulus arvensis L. group.

Topical administration of Trigonella foenum-graceum L. and the Convolvulus arvensis L, with rich flavonoid contents can be beneficial in treatment of burn wound healing.

Recently, many studies have been conducted on the role of selenium in autoimmune diseases. Trace element deficiency is not an uncommon finding in autoimmune diseases. This deficiency may be a consequence of autoimmune diseases or may contribute to their aetiology. The aim of this study was to investigate the level of selenium in patients with sarcoidosis compared to healthy controls in teaching hospitals affiliated with Mazandaran University of Medical Sciences.

In this case-control study, serum selenium levels were measured in 42 patients with sarcoidosis and compared with 42 healthy, age- and sex-matched controls. Two cc non-fasting blood samples were collected. The serum selenium level was measured using Atomic Absorption Spectrometry (AAS). The normal range for serum selenium is between 46 to 143 micrograms per liter.

The mean ages in the case group and controls were 47.45±7.6 and 47.24±7.23 years, respectively (P=0.898). Serum selenium levels were significantly lower than the controls (82.42±24.11 vs. 94.79±27.01 µg/ml, P=0.03). In case group, there was no significant difference between serum selenium levels and sex (P=0.165). The study showed no relationship between serum selenium levels and age (P=0.258), duration of disease (P=0.121), duration of treatment (P=0.837), delay in initiation of treatment (P=0.316), and type of treatment (P=0.859).

Serum selenium levels were significantly lower in patients with sarcoidosis than the healthy controls, so, these patients may benefit from selenium supplements.

Antioxidants can prevent oxidative damage caused by increased production of free radicals in oral and dental diseases. In this research, the total antioxidant capacity (TAC) of saliva in patients with acute apical abscess before and after root canal treatment was investigated and compared with a control group.

In this case-control study, salivary antioxidant levels of 20 patients with acute apical abscess were collected before and three weeks after root canal treatment. Also, 20 healthy people (without tooth decay and abscess and without any systemic diseases) were considered as the control group. The ferric reducing ability of plasma (FRAP) was used to measure total antioxidant in the saliva samples and the TAC was evaluated. Then, all data were analyzed in SPSS V16.

The mean salivary TAC in the case group was 298.8±174.9 µmol/L before treatment and 450.9±145.2 µmol/L after treatment (P=0.009). However, there was no significant difference in the TAC between the case group after root canal treatment and the control group (P=0.056).

This study showed that effective treatment of acute apical abscess can increase the overall antioxidant capacity, reduce oxidative stress, and have an effective role in repairing the damage caused by the activity of free radicals.

Reduced function of immune system and underlying diseases make older people more susceptible to Shingles (herpes zoster). The present study aimed to compare the clinical findings and underlying conditions between patients with herpes zoster under 50 years and over 50 years of age.

This cross-sectional descriptive study included all patients who were admitted or hospitalized in Sari hospitals due to herpes zoster in 2016-2018 with complete medical records. Information was collected by census.

There were 180 cases who were investigated according to their age. In patients under 50 years of age, 97 had no underlying diseases, while diabetes, hypertension, malignancy, and cardiovascular diseases were seen in 6, 4, 3, and 12 patients, respectively.  In patients over 50 years of age, 21 were found with no underlying diseases, but 15, 2, 11, and 9 cases had diabetes, hypertension, different types of malignancies, and cardiovascular diseases, respectively. The frequency of underlying diseases in patients with cancer and diabetes in patients with herpes zoster were significantly higher in people over 50 years of age (P= 0.042 and P= 0.05).

Given the risk factors presented in this study, patients with underlying diseases or those on immunosuppressive drugs are required to be closely monitored and receive early treatments as soon as developing herpes zoster to avoid severe complications.

Depression is a psychiatric disorder that causes major disabilities and has negative effects on the quality of life of people all over the world. In recent years, non-pharmacological treatments that may improve depression have received much attention. The purpose of this research was to systematically review primary experimental studies on the effectiveness of religion-based cognitive behavioral therapy (CBT) in treatment of depression symptoms.

This systematic review was carried out using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). The search was performed in Cochrane library, PubMed, Web of Science, EMbase, Magiran SID, International Clinical Trials Registry Platform (ICTRP), and Clinicaltrials.gov using the following keywords:  depression, cognitive-behavioral therapy, and religion-based. The search was limited to articles published in Farsi and English until 2022. We studied articles that investigated the effectiveness of religion-based cognitive-behavioral therapy compared to no intervention or conventional cognitive-behavioral therapy in improving depressive symptoms. Bias assessment of experimental and semi-experimental studies was done by RoB 2 and ROBINS-I scales, respectively.

In the initial search, 1037 articles were found. Considering inclusion criteria and qualitative evaluation of the articles, finally 20 studies were selected. A total of 1682 samples were studied in these articles. The majority of samples were female patients, and major depressive disorder and depressive mood were the most common disorders. All studies indicated the effectiveness of religion-based CBT in reducing depressive symptoms.

Further experimental studies with larger sample size are needed to investigate the role of gender and different types of depression on the effectiveness of religion-based CBT in reducing the severity of depression.

The cell culture technique is one of the tools used in cellular and molecular biology such as cancer cell culture, regenerative medicine, and drug discovery. In recent years, three-dimensional (3D) cell culture has gained attention in cancer research. Scaffolds are porous structures that are used in 3D cell culture to mimic the 3D architecture of tissues and provide more accurate information about tumor cells, extracellular matrix (ECM), and tumor characteristics. These scaffolds are based on synthetic polymers or ECM components and can promote the signaling pathways, survival, and proliferation of cancer cells. Natural and synthetic polymers, hydrogels and microspheres can be used to make 3D scaffolds. 3D cancer cell culture technology can improve cancer treatment. This review article discusses recent advances in the field of scaffold-based 3D models in cancer tissues.

Cosmetics are daily chemical industrial products used for cleaning, health care, and beauty purposes. Sometimes these products are contaminated by heavy metals, unwanted chemicals, and other dangerous substances that can lead to environmental pollution and cause various diseases and physiological side effects in humans. N-nitrosodiethanolamine compounds are among the unwanted contaminants created during the production of cosmetic products. In recent years, various qualitative and quantitative analytical methods have been used for detection of nitrosamine compounds in many products, and various techniques were developed to address the limitations of previous methods. This study reviewed approaches developed to detect N-nitrosodiethanolamine compounds, including microextraction techniques and application of nanotechnology in order to design accurate analytical methods and high sensitivity nanosensors to overcome the limitations of current methods and designing practical and cost-effective systems.