مجله دانشگاه علوم پزشکی مازندران
پیاپی 226 (آبان 1402)

Background and

Alzheimer's disease is a neurodegenerative disorder associated with the accumulation of amyloid plaques in neurons. Increase in blood cholesterol leads to an increase in the deposition of these proteins in neurons and results in memory degradation. In the present study, the effect of rosuvastatin as a cholesterol-lowering drug was investigated in Alzheimer's rats.

Animals were divided into four groups: control, streptozotocin (to induce Alzheimer's), rosuvastatin, and rosuvastatin with streptozotocin. In intracerebroventricular injection, the groups received saline (1 μg/rat) or streptozotocin (3 mg/kg). Daily gavage of saline (1 mg/kg) or rosuvastatin (10, 20 mg/kg) started one day before cannulation and continued for two weeks. At the end of the treatment period, the rats' memory, number of healthy neurons in CA1 area, and serum oxidative stress indices were measured.

Intraventricular injection of streptozotocin significantly decreased memory recall, the number of intact neurons in CA1 area, total antioxidant power, and superoxide dismutase enzyme level; and increased serum malondialdehyde levels compared to the control group (P<0.001). In the group receiving rosuvastatin (20 mg/kg), the above indexes were significantly reversed compared to the streptozotocin group (P<0.001), which means improved memory. In rosuvastatin groups (10 and 20 mg/kg) alone, there was no significant difference in the above indexes compared to the control group (P>0.05).

Streptozotocin leads to cell death in the CA1 region and memory dysfunction through various mechanisms such as increasing oxidative stress. It seems that rosuvastatin is able to prevent the destructive effects of streptozotocin on memory and learning by inhibiting oxidative stress indicators.

Background and

Hypoxia can lead to body function impairment and may cause a variety of physiological abnormalities. Hypoxia is linked to the pathology of acute mountain sickness, cardiovascular disease, and stroke, and is the leading cause of death in many countries. Feijoa sellowiana, Nepeta pogonosperma, and Cucumis melo are plants with good antioxidant activities.

Protective effects of F. sellowiana, N. pogonosperma fruits and C. melo aerial parts against hypoxia-induced lethality in mice were evaluated by three experimental models of hypoxia, including asphyctic, haemic, and circulatory models.

F. sellowiana, and N. pogonosperma extracts had good protective effects and increased the survival time of male mice even at their lowest doses, 31.25 and 62.5 mg/kg. In all the models, they were effective at low doses and showed a similar degree of efficacy as propranolol and phenytoin, which were used as positive controls. C. melo fruit extract showed a weak effect in these tests. It was effective only in the dose of 250 mg/kg in blood circulatory model of hypoxia.

Extracts showed very good protective effects against hypoxia in all the hypoxic models. Even at low doses, they were able to show the same activity of positive controls. It seems that these plants have a good potential for the treatment of hypoxic conditions.

Background &

Brain tumors are one of the deadliest malignancies that can directly affect the brain, and are often accompanied by executive function and memory disorders. The aim of this research was to investigate the effectiveness of endurance exercise and nano curcumin consumption on short-term memory of rats with glioblastoma multiforme brain tumor.
Materials &

In this experimental study, 35 healthy male Wistar rats were randomly divided into seven groups of five including: the basic healthy control group, 4-week healthy control, basic cancer control, 4-week cancer control, cancer + nano curcumin group, cancer + exercise, and cancer + practice + nano curcumin. One week after the injection of cancer cells into the frontal cortex, the animals entered the main exercise program on the treadmill (4 weeks, 18 m/min, and 3 days a week). In the end, the rats were sacrificed, the data were collected, and the results were analyzed using one-way analysis of variance and Tukey's post hoc statistical tests.

The results showed that endurance exercise and nano curcumin consumption significantly reduced the tumor volume in the cancer + exercise + nano curcumin group (P= 0.001), and also caused a significant increase in short-term memory in the studied groups compared to the 4-week cancer group (P= 0.001).

Probably, performing endurance exercises along with the use of nano curcumin can improve short-term memory in rats with brain tumors, in addition to reducing tumor volume.

Background and

Psoriasis is an autoimmune inflammatory disease with major skin involvement. Calcipotriol as a vitamin-D analogue is one of the common drugs for topical treatment of psoriasis. Local drug delivery, due to higher concentration of drug at the sites of inflammation, is more effective and causes fewer systemic side effects. Limited skin penetration and durability of common topical formulations reduce the efficacy of treatment. In this study, we aimed to investigate the effect of solid lipid nanoparticles loaded with calcipotriol on local drug delivery.

In the present study, which is an interventional in vivo study, Solid Lipid Nanoparticle (SLN) was prepared by melting method and mixed with semi-solid base (cream). Then the effectiveness of the final formulation was investigated on the psoriasis model induced by imiquimod 5% in BALB/c mice. Three groups were included in this investigation: negative control (no treatment), positive control (conventional calcipotriol cream), and SLN (SLN cream with calcipotriol).

The results of the present study showed that, the SLN cream significantly reduced inflammatory scores compared to the other two groups on day five (P<0.0001). In addition, drug loading into SLN significantly increased the rate of healing and reduced inflammation.

This study showed that calcipotriol loading with SLN can improve the quality and the rate of treatment of skin lesions caused by psoriasis.

Background and

Minoxidil is one of the agents that can treat hair growth disorders, including alopecia, by increasing the anagen period. Due to the nature of minoxidil, the permeability of the drug to the skin surface is negligible. Therefore, the purpose of this study was to design and evaluate microemulsion formulations in order to increase skin permeability of minoxidil.

Microemulsions containing 2% minoxidil were prepared with an appropriate amount of oil phase, surfactant, and co-surfactant. The medicinal substance was dissolved in the oily phase. The physicochemical properties of the microemulsions, including particle size, viscosity, release, skin permeation through rat skin as well as the rate of drug permeation through rat skin, were evaluated using Franz cells.

The particle size of microemulsions was in the range of 5.45-10.4 nm, viscosity was 113.2-199.2 centipoise. This study showed that the parameters of drug release percentage in the second hour, drug release percentage in the 24th hour, viscosity and Dapp were significantly related to independent variables(P<0.05). Increasing the percentage of water and the percentage of oil has increased the amount of drug release in 24 hours. Increasing the percentage of oil and decreasing the percentage of water can lead to an increase in viscosity, and increasing the percentage of water can increase the amount of Dapp in microemulsions.

The prepared formulations were able to significantly increase the skin permeability of minoxidil.

Background and

Nowadays, the use of traditional herbal remedies along with exercise has become very popular for the prevention and treatment of diseases. The aim of this study was to investigate acute effect of aged garlic extract on metabolic rate, substrate oxidation, and salivary cortisol during and after high-intensity interval exercise (HIIE) in inactive women.

The study population included ten inactive women in Birjand (age 24±6 years, BMI 22-23 kg/m2). Individuals participated in two separate sessions (one week apart). In the first session, aged garlic supplements (600 mg) were taken one hour before HIIE. In the second session, the placebo (600 mg of starch) was taken. The HIIE program consisted of 11 alternates (1-minute with 90% vVO2max followed by 2-minute rest intervals with 60% vVO2max). Pre, during, and after HIIE, oxygen consumption and carbon dioxide excretion were measured using the respiratory gas analyzer in order to calculate metabolic rate (Energy Expenditure, VO2) and substrate oxidation (Fat Oxidation, Respiratory Exchange Ratio (RER)). Salivary cortisol was measured using chemiluminescence method. Repeated analysis of variance was applied for statistical analysis of the data.

The results revealed that there was no significant difference in VO2 (P=0.28), Fat Oxidation (P=0.09), RER (P=0.083), and energy expenditure (P=0.76) between aged garlic and placebo intake. There was no significant difference in salivary cortisol (P= 0.66) either.

Generally, aged garlic supplement intake along with HIIE does not have any effect on metabolic rate, substrate oxidation, and cortisol level in inactive women.

Background and

Emergence of multidrug resistance (MDR) among Streptococcus agalactiae isolated from pregnant women and the presence of polysaccharide capsules in these strains play a significant role in pathogenicity. Therefore, the aim of this study was to investigate the prevalence of antibiotic resistance, multidrug resistance, and Ia and Ib capsular types in these strains.

Vaginal samples were transferred to Todd-Hewitt Broth medium. After 24 hours, they were inoculated on the blood agar medium, and then the bacteria were identified using standard methods. The antibiotic resistance pattern of the isolates was determined by the disk agar diffusion method. Then, the bacterial DNA was extracted and the capsular genes were identified using PCR method.

The prevalence of colonization in pregnant women was 23.25%. Tetracycline with 94.33% resistance rate was the least effective drug, while 78.3%, 81.13% and 83.01% of the isolates were non-susceptible to ofloxacin, erythromycin and quinupristin-dalfopristin, respectively. Also, 78.3% of the isolates were sensitive to penicillin. Meanwhile, 94 (88.7%) isolates were MDR, while 20 (18.86%) isolates and 32 (30.18%) isolates had the Ia and Ib capsular types, respectively.

Penicillin is a suitable drug for prophylaxis in high-risk pregnant women in this region. The high prevalence of MDR strains indicates the lack of proper management of antibiotics. In addition, the high prevalence of capsular types Ib and Ia, especially in MDR strains, shows the importance of these serotypes for designing capsular vaccines.

Background and

Low frequency noise (LFN), even at low levels, can have an adverse effect on individual's mental health and performance. However, personality trait is one of the most important influencing factors. Therefore, the aim of this study was to investigate the perception of loudness, sensitivity, and annoyance of LFN in relation to personality traits.

This semi-experimental research was conducted on 40 students of Mazandaran University of Medical Sciences in 2022. The Eysenck Personality Questionnaire‐Revised (EPQ‐R) was used to assess personality traits. Participants were exposed to LFN at Equivalent continuous sound level (Leq=65 dB in A-weighted) for one hour in an acoustic room. Then questionnaires of noise annoyance, Weinstein noise sensitivity, and loudness perception were used, respectively. Finally, statistical analysis was performed using SPSS V25 and applying Chi-square, independent t-test, and multivariate analysis of variance (MANOVA).

The mean value of annoyance, sensitivity, and noise perception were 5±2.05, 65.2±14.88, and 3.55±0.68, respectively. The results of the study indicated that extroverted and introverted personality traits did not have a significant correlation with annoyance, sensitivity, or perception of loudness (P>0.05) while the results of the MANOVA test showed that neuroticism was the most influential factor on sensitivity (P<0.05).

The findings of this study have confirmed that personality traits, such as neuroticism, can significantly affect the sensitivity of individuals when exposed to low frequency noise. As a result, it is important to consider factors beyond engineering control solutions to address and  reduce the levels of annoyance caused by noise. Therefore, other influential factors such as individuals' personality traits should also be taken into account.

Background and

Infertility is a major concern for public health and is considered as one of the most important crises in life, which leads to psychological problems such as infertility stress and marital boredom. Therefore, the aim of the present study was to investigate the effectiveness of cognitive-behavioral therapy on infertility stress and marital burnout in infertile women.

In this clinical trial, 43 infertile women were selected from specialized obstetrics and gynecology clinic in Sari, 2023. They were recruited using non-random and convenience sampling. They were then randomly divided into two groups of intervention (CBT, n=15) and control (without any treatment, n=15). The CBT was implemented according to the Bieling protocol during weekly sessions of 45 minutes for twelve weeks. The participants were evaluated at pre-test, post-test and 45days follow-up using infertility stress by Newton et al (1999) scale and marital burnout by Pines (2005) scale. Data analysis was performed applying repeated measures ANOVA in SPSS V24.

In the experimental group, the average scores in the three phases of pre-test, post-test and follow-up for infertility stress were (200.866±19.471), (146.066±12.719), and (153.066±16.086), respectively, and for marital burnout were (97.533±12.052), (67.065±5.750), and (74.666±8.286), respectively, which had a significant decrease in the two stages of post-test and follow-up compared to the pre-test stage (P<0.05), but no significant difference was observed in the control group (P>0.05). Also the results showed that cognitive-behavioral therapy in infertile women reduced infertility stress (F=24.700, P=0.000) and marital burnout (F=146.146, P=0.001).

The results indicated the effectiveness of cognitive-behavioral therapy in reducing infertility stress and marital burnout in infertile women, which can be used along with other medical treatment methods in infertility clinics to reduce the psychological needs and problems of infertile women.

Background and

Hypothyroidism is one of the most common endocrine diseases that affects the basic metabolism and has a great impact on the quality of life of patients. Despite the treatment, some of the patients are still symptomatic. Persian medicine pays attention to mizaj as one of the important principles of effective treatment. Therefore, the purpose of this study was to determine the frequency of mizaj types in hypothyroid patients.

This descriptive cross-sectional study was conducted on under treatment hypothyroid patients, aged 20 to 60 years, who referred to Sari Touba Clinic from January to June 2023. The mizaj of the patients was determined using a standard questionnaire.

Out of 300 eligible female hypothyroid patients, a total of 194 participated in the study. In terms of simple temperament, more than half of the patients were cold and 72.2% of the patients were wet. In terms of mixed temperament, 41% of patients were cold and wet. Also, there was a statistically significant relationship between BMI and dry or wet temperament.

This study showed that the predominant temperament of hypothyroid disease is cold and wet; therefore, in order to achieve complementary treatment for the disease and choose best medicinal interventions based on the principles of Persian medicine, hypothyroid patients should avoid all measures that increase coldness and wetness. In other words, measures that increase coldness and wetness should be avoided in hypothyroid patients as much as possible.

Background and

Despite so many advances in the treatment of heart failure, the rate of readmission is still relatively high which imposes additional costs on patients and hospitals. Therefore, this study was designed and implemented to determine the causes of rehospitalization of heart failure patients admitted to Fatemeh Zahra Heart Center in Sari during 2022.

In this descriptive study, 309 patients with heart failure, who were admitted at Fatemeh Zahra Heart center for the second time, were selected by available sampling method during 2022. The data collection tool was a questionnaire which included demographic information as well as factors associated with readmission of heart failure patients. The qualitative content validity of the questionnaire was checked and confirmed by five cardiologists. The samples were analyzed using SPSS V21 applying descriptive statistics of relative frequency, absolute frequency, mean, and standard deviation.

Dyspnea was reported in 88% of the patients, and according to the NYHA Class evaluation criteria, the highest level of severity was 2 (in 44% of cases). An increase in chest pain before rehospitalization was also reported in 30% of the patients, and according to the CCS Class evaluation criteria, the highest level of severity was 2 (in 54% of cases) Failure to comply with the rehabilitation program was observed among 74% of patients who had a rehabilitation program. The other main reasons for readmission of heart failure patients in order of priority were failure to comply with medication regimen (28% of patients), palpitation (28%), stressful event (22%), heavy activity (21%), non-adherence to food diet (21%), smoking (7%), infectious disease (4%), discontinuation of medication (4%), and alcohol use (3%).
Conclusion.: Considering that dyspnea was the main reason for rehospitalization of heart failure patients, and non-compliance with the rehabilitation program, non-observance of the drug, and food diet regimen accounted for a high percentage of readmission, it is recommended to emphasize compliance with the rehabilitation program due to its great impact on improving the respiratory condition. Furthermore, it is beneficial to educate patients on adhereing to their diet and medication, using consultations, and following the doctors' recommendations after discharge. This can be effective in preventing rehospitalization of patients and improving the quality of their life.

Background and

Obesity is a growing public health concern worldwide. This study examined the prevalence of obesity/overweight and its relation with cumulative socioeconomic risk in women of reproductive age in Mazandaran province, Iran.

In this descriptive correlational study using a multi-stage cluster sampling method, 540 married women aged 15-45 referred to primary health centers in Mazandaran province were recruited (2020). Body mass index was categorized into three levels: obese (≥30), overweight (25-29.9), and normal (18.5-24.9). Socio-economic status was classified using generalized Oaxaca-Blinder decomposition method. Each of the socio-economic variables (8 indicators) was given a score of zero or one, and then the scores were added up. The scores of ≥5, 3-5, and ≤2 were considered good, average, and poor, respectively. The relationship between socio-economic variables and different levels of body mass index was assessed once separately and once cumulatively in binary regression.

The prevalence of obesity and overweight was 23.3% and 48.5%, respectively. The socio-economic status of 26.2% of the participants was classified as good, 64.3% as average, and 9.5% as poor. There was a significant positive and negative relationship between obesity in women with their number of children (OR: 2.72, 95% CI: 1.50-5.17) and obesity in their parents (OR: 0.43, 95% CI: 0.19-0.94) respectively. Statistical tests did not show significant relationship between women's obesity and their cumulative socio-economic status (P>0.05).

The prevalence of obesity and overweight among women of reproductive age, regardless of their socio-economic status, has reached epidemic proportions. Extensive studies are suggested to better understand the factors that contribute to obesity and to provide a more accurate explanation for the rapid increase in obesity among various socio-economic groups.

Background and

Production of household infectious waste is a constant concern and problem in home medical care services. Considering the increase of household infectious waste in recent years, this study was conducted with the aim of identifying strategies to improve the management of this type of waste.

This qualitative study was conducted using the content analysis method. Face-to-face semi-structured interviews were conducted with 15 experts in the field of waste management. These people were selected purposefully. Four criteria of acceptability, confirmability, dependability, and transferability by Guba and Lincoln were used to ensure the consistency and accuracy of the results. Data classification was done using MAXQDA2018 software. The data collection period was from 22 November 2023 to 21 January 2023.

Data analysis showed 13 main topics, including: education and culture, management measures, provision of resources, social and legal support, technology, control and evaluation, waste generation, collection, temporary storage, transportation, processing, disposal, and management challenges; and 30 subtopics.

The results of the present study identified different strategies for improving the methods of household infectious waste management in Iran based on the experiences of the participants. This could be a crucial step towards addressing the challenges and achieving better outcomes in the management of these wastes.

Background and

Ellagic acid is a natural polyphenol compound with potential antioxidant properties that is present in most fruits, seeds, and vegetables. Therefore, this study was designed to investigate the effects of ellagic acid administration on the liver damage model caused by thioacetamide in rats.

In this experimental study, 60 male Wistar rats weighing approximately 200 grams were randomly divided into six groups (n=10). Liver damage was caused by a single dose (100 mg/kg) administration of thioacetamide for three consecutive days. Different doses of ellagic acid (10, 25 and 50 mg/kg) were administered to the sick mice as a single dose for three consecutive days. Finally, 24 hours after the last injection, biochemical factors (ALP, AST, ALT, LDH, bilirubin, total protein), oxidative stress markers (LPO, ROS, FRAP, GSH), ammonium ion concentration, and movement activity of the mice were examined. One-way analysis of variance and Tukey's post hoc test were used for statistical analysis.

Thioacetamide led to a significant increase in serum biochemical factors and oxidative stress markers in the studied groups (P<0.05). In addition, the amount of ammonium ion in the plasma, as a key effective factor in hepatic encephalopathy, was greatly increased in animals receiving thioacetamide (P<0.05). Administration of ellagic acid in different doses significantly reduced liver damage and plasma ammonium concentration (P<0.05).

The results of this study showed that ellagic acid reduced liver damage caused by thioacetamide through its antioxidant activities.

Background and

Inflammation plays an important role in the development of neuropathic pain (NP). Considering the anti-inflammatory effects of mesenchymal stem cells (MSCs) and their conditioned medium (CM), we aimed to investigate the effect of MSC-CM on the expression of CCL3 and CCL4 genes in the spinal cord of rats with NP.

In this experimental-interventional study, 28 male Wistar rats weighing 200-300 grams were included. NP was induced in male rats using the chronic constriction injury (CCI) model of the sciatic nerve. MSCs-CM was injected intraperitoneally (1ml) into each rat in the experimental group one day before surgery (-1), and 7 and 11 days after the surgery, while the rats of control group received DMEM. At the end of the study (day 15), the expression level of CCL3 and CCL4 genes in the animals’ spinal cord was measured using Real time PCR.

Molecular studies showed a significant decrease in CCL3 gene expression (P<0.05) in CM treated animals compared to the control group, but in term of CCL4 gene expression, there was no significant difference between the groups.

Anti-NP effects of MSCs-CM seem to be partly mediated through downregulation of CCL3 chemokine in the spinal cord.

Background and

Prostate cancer is the second cause of cancer-related death in men. Early diagnosis and identification of prognostic factors help to predict clinical outcome and select the most effective treatment protocol in each patient. The relationship between CD117 expression and various tumor prognoses has been identified and there is evidence for the role of this marker in prostate cancer pathogenesis. So, the aim of this study was to evaluate CD117 marker expression in prostate benign hyperplasia and adenocarcinoma, and to find its association with Gleason grade.

In this cross-sectional study, paraffin blocks of tissue samples obtained from 85 patients with prostatic benign hyperplasia and 78 patients with prostatic adenocarcinoma, who referred to Shahid Mostafa Khomeini hospital during 2018 to 2021, were immunohistochemically stained by anti-CD117 antibody. Membranous and cytoplasmic staining in more than 10% of epithelial tumor cells was considered as positive result.

Positive CD117 expression was found in 27.1% of prostatic benign hyperplasia and 50% of prostatic adenocarcinoma samples showed a statistically significant difference (P=0.003). There was no significant relationship between CD117 status expression and primary Gleason grade in prostatic adenocarcinoma samples (P=0.166); however, secondary Gleason grade and total Gleason score had a significant relationship with CD117 expression status (P=0.002 and P=0.017, respectively).

CD117 expression was higher in prostatic carcinoma compared to benign prostatic hyperplasia and its higher expression was associated with higher Gleason grade as one of the most important prognostic factors in prostatic carcinoma

Background and

Seborrheic dermatitis (SD) is a chronic skin condition that is accompanied by scaling and itching. Stress and mental rumination followed by the disease affect the quality of life. The aim of this study was to investigate the effect of seborrheic dermatitis on the quality of life and to compare it with the quality of life of healthy people.

This study was a cross-sectional study. The study sample included 60 randomly selected patients with seborrheic dermatitis who referred to Bouali and Tooba dermatology clinics in Sari during 2019-2020. Two questionnaires (DLQI and SF-36) were used to assess general quality of life in patients.

The relationship between the disease and occupation was statistically significant. There was a significant relationship between smoking and seborrheic dermatitis. We also found a significant relationship between the frequency of recurrences and quality of life. The mean of physical and social function in the healthy group was higher than its value for the patient group, but the difference was not significant.

Our study showed that age, education, occupation, and smoking are factors that contribute to seborrheic dermatitis. Moreover, the findings revealed that physical and mental health as well as quality of life were less affected in the married group compared to the single group.

Background and

Diabetes is one of the most common diseases in the world, and blood sugar control and periodontal diseases are mutually related. The aim of this study was to investigate the periodontal status of people with type 2 diabetes referred to Imam Khomeini and Touba Medical Centers in Sari during 2018-2019.

This descriptive cross-sectional study included 107 randomly selected patients who were diagnosed with type 2 diabetes (controlled and uncontrolled). HbA1C values were evaluated to check the diabetes status of the patients, and Community Periodontal Index (CPI) was evaluated to check the periodontal status. Statistical analysis was performed using SPSS V24.

All the 107 patients were females, with an average age of 49.7±11.2. Diabetes was controlled in 46.7% of the patients, while 37.4% of the patients had uncontrolled diabetes. In the examination of periodontal condition, 40.2% were healthy, 30.8% had gingivitis, and 29% had periodontitis. The value of CPI was 1.8 ± 0.5, and code 3 (envelope 4-5 mm) was the most frequent index.

Since the highest frequency of Community Periodontal Index of Treatment Needs (CPITN) was related to code 3 (4-5 mm packet depth), it is recommended that diabetic patients fulfill their oral hygiene and make regular visits to the dentist for follow up examinations.

Background and

Hospital infections remain a significant health concern despite advancements in treatment methods. The emergence and spread of pathogens with multiple resistance remain a global health issue. The purpose of this study was to investigate the prevalence of nosocomial infections and determine the antibiotic resistance pattern in Razi Ghaemshahr Hospital, Mazandaran.

This descriptive cross-sectional study was carried out at Razi Ghaemshahr Hospital in Mazandaran province during 2016-2017. Positive cultures from hospitalized patients were used as samples and subjected to antibiotic resistance pattern analysis using the disk diffusion method.

Out of the 672 hospitalized patients in different wards, the infectious ward had the highest frequency distribution of patients (40%). The most commonly isolated pathogens were Escherichia coli (26.2%), Acinetobacter baumannii (14.7%), Enterobacter (14.1%), Pseudomonas aeroginosa (13.5%), and Citrobacter (12.8%). The pathogens were highly resistant to cephalosporins, fluoroquinolones, beta-lactamase inhibitors, and carbapenems.

It was found that the most frequently isolated pathogen was Escherichia coli. The emergence of Citrobacter with high antibiotic resistance can possibly be attributed to a shift in the prevalence pattern of microorganisms within this hospital

Background and

Familiarity with procedures method makes the patient cooperate. Besides, using virtual reality headsets decreases pain through involving patients in a multidimensional space. Stitching causes the child to not cooperate due to the pain occurring during the procedure. Therefore, this study combined these two methods to investigate the effect of familiarization with stitching through virtual reality headset on children's pain intensity and parents' satisfaction during stitching.

The present study was a clinical trial. The statistical population consisted of 60 children aged 5-7 years with a cut in the limb or head. These children were selected by the convenience method and randomly allocated into two groups. Pain related to laceration was measured using Visual Analog Scale in both groups before the intervention. In the intervention group, virtual headset was used 1 to 3 minutes before stitching (playing 1 minute and 30 seconds animation containing how to stitch and getting familiar with the hospital environment). After the procedure, the child's pain intensity was measured again. Parents were asked to complete a parents' satisfaction questionnaire on pain management after stitching. Finally, the data were analyzed using SPSS V16.

The demographic data did not show any significant differences. The results showed a statistically significant difference between the pain intensity of children in the control (8.6±1.67) and intervention (3.97±3.21) groups (P=0.001). Parents' satisfaction (control 48.03±11.76 and intervention 68.83±8.67) with pain management also showed a statistically significant difference between the two groups (P=0.001).

It seems that using virtual reality for the purpose of familiarization reduces the intensity of pain in children during stitching and increases parents' satisfaction. Therefore, it is recommended to use this method as a non-drug, safe, non-invasive, and cheap method.

In various fields of oncology and radiation therapy, scientists continue to explore and develop innovative treatments that are less toxic and more effective to improve local tumor control rates, patient survival, and quality of life. In the development process of radiation therapy, continuous improvement is observed in different methods of radiation therapy, and in particular, adopted radiotherapy (ART) can be considered a developing phenomenon in this regard. In this review article, by describing the ART method, its classification in time domain is first discussed, and then different ART methods, the capabilities and scope of these methods and the way to overcome their limitations and defects are discussed.

Background and

Considering the effects of dengue fever on the health of people in the society and the role of climatic and environmental factors on the spread of this disease, this review study has investigated the climatic and environmental factors affecting the prevalence of dengue fever.

In this review, the academic papers, in English and persian languages, published until the beginning of August 2022 were investigated. These articles were searched in scientific databasese of Scopus, ScienceDirect, PubMed, Web of Science and Google Scholar, using keywords such as "dengue fever", "dengue vector", "vector mosquito", "Aedes mosquito", "environmental factors", and "weather factors". Endnote X8 software was also used to organize, and study titles and abstracts of the articles.

Considering the impacts of environmental changes on mosquito population and its subsequent effect on the occurrence of dengue fever, the present study showed that changes in climatic factors including air temperature, rainfall, and humidity affect the frequency of dengue disease vectors. Land use and land cover change can affect mosquito population and dengue transmission by changing local ecology. Household waste and its accumulation around residential houses can also hold a significant amount of water as environmental pollutants and can be considered as a habitat for mosquito larvae such as Aedes species.

The analysis of climatic and environmental factors has shown that environmental factors and weather changes can affect the occurrence of dengue fever.

Correction to: Effects of Low-Frequency Electromagnetic Fields on the Histopathology of Liver Tissues in Rat Offspring

Mohammad Hassan Kalantar Neyestanaki1,
Homa Soleimani2,
Sahar Ghaffari Khaligh3,
Parvindokht Bayat4

1 Medical Doctor, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
2 Assistant Professor, Department of Medical Physics, Faculty of Paramedicine, Arak University of Medical Sciences, Arak, Iran
3 Assistant Professor, Department of Pathology, Faculty of Veterinary Medicine, Semnan University, Semnan, Iran
4 Professor, Department of Medical Anatomy, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
Corresponding Author: Homa Soleimani - Faculty of Paramedicine, Arak University of Medical Sciences, Arak, Iran.  (E-mail: soleimani963120@gmail.com)
In the article published in volume 33, issue 225, 2023, the name of corresponding author is changed from Mohammad Hassan Kalantar Neyestanaki to Homa Soleimani.