مجله دانشگاه علوم پزشکی مازندران
پیاپی 228 (دی 1402)

Ulcerative colitis is a kind of inflammatory bowel disease that involves factors such as genetic predisposition, environmental factors, and disproportionate function of the mucosal immune system in response to intestinal microbial flora. Platelet-rich plasma (PRP) is a blood derivative that has anti-inflammatory and cell-regenerating properties. This study aimed to investigate the effects of PRP on the clinical and inflammatory manifestations in an experimental model of ulcerative colitis.

In this experiment, male BALB/c mice were segregated into four groups, each consisting of 10 mice: the healthy group (negative control), the colitis group without treatment (positive control), the colitis group receiving PRP, and colitis group receiving sulfasalazine. All animals, except for those in the negative control group, were subjected to colitis induction via intrarectal injection of 100 µl of 4% acetic acid. The treatment regimen commenced after the onset of UC symptoms. The mice were euthanasia after 15 days of the last injection, and the disease activity index, as well as the inflammatory factors, were assessed.

According to the results, the treatment groups showed a significant decrease in disease activity index, the severity of inflammation, the level of MPO, NO, and IL-1β, IL-6, and TNF-α cytokines expression and production, as well as inflammatory genes COX2 and iNOS expression, compared to the positive control group.

The results showed that PRP has favorable anti-inflammatory effects in ulcerative colitis and after additional evaluations, it can be used as an adjunctive treatment along with the drugs used in the treatment of ulcerative colitis patients.

Antimicrobial property is one of the important features of sealers, which plays an essential role in limiting microorganisms from the root canal system. This study was conducted to investigate the antimicrobial properties of EndosealMTA, Sure seal root, and AH26 sealers on Enterococcus faecalis bacteria.

In this study, ceramic sealers Endoseal MTA, suersealroot, and resin sealer AH26 were used. Each of these sealers was placed in wells in the agar medium for 10-15 minutes to spread and then immediately incubated at 35±2°C for 24 hours. Statistical analysis was performed using SPSS (V.22), with the application of Shapiro-Wilk, Kruskal-Wallis, and ANOVA tests.

The highest mean halo of non-growth was related to the Endoseal MTA group. The antimicrobial property of Suresealroot sealer was lower compared to AH26 sealer, but this difference was not statistically significant. (P=0.368). The antimicrobial property of Endoseal MTA sealer was higher compared to AH26 sealer, but this difference was not statistically significant (P=0.368). The antimicrobial properties of Suresealroot sealer were lower compared to Endoseal MTA, but there was no statistically significant difference (P=0.48).

Ceramic sealers Suresealroot, Endo seal MTA and AH26 resin sealer showed antimicrobial properties against Enterococcus faecalis; But the antimicrobial properties of Ceramic Sealers were not different from resin sealer on Enterococcus faecalis

Many patients fail to reach the expected results, even with the very considerable strides forward in the treatment of hypertension (HTN). They undergo serious complications after this condition remains uncontrolled. Patients' perceptions regarding the importance of Islamic self-care may be the occasion for managing chronic diseases. The present study aimed to investigate the effectiveness of the Islamic self-care model on blood pressure (BP) and medication adherence (MA) among older adults living with HTN.

Utilizing a randomized controlled trial in 2019 in Amol City of Iran, 60 elderly patients suffering from high blood pressure were assigned to two intervention and control groups in the form of random block allocation. Then, their BP and MA were measured using a dial sphygmomanometer and Morisky questionnaire, respectively.  Designed for four weeks, the intervention group participated in an HTN-management education program, putting much emphasis on proper nutrition within the framework of the Islamic self-care model and gaining divine satisfaction. Simultaneously, the control group received a similar scientific HTN management and medication adherence education program. Following the re-measurement of BP and MA in both groups, the data were analyzed using descriptive statistical tests, Chi-square, Fisher, independent-samples t-test, and analysis of covariance.

In the pre-intervention phase, there was no significant difference between the two groups in the mean BP indices and MA. At the post-intervention, results revealed a significant reduction in the average systolic blood pressure (133.125±8.95) and diastolic (78.33±61.4) of the Islamic self-care group compared to systolic blood pressure (141.33±10.16) and diastolic (82.0±4.27) in the control group (P>0.001). Also, there was a significant improvement in the MA score in the Islamic self-care group (1.07±1.01) compared to the control group (2.43±1.38) (P<0.001).

The Islamic self-care model was found to be effective in managing the average BP and MA of patients.

Although fear and anxiety during pregnancy can be associated with adverse pregnancy outcomes, the existing studies show various results. This study aimed to investigate the relationship between fear and anxiety of COVID-19 and childbirth experiences.

This longitudinal study was conducted in six cities of Mazandaran province between June 2021 to February of the same year on 278 pregnant women using a multi-stage sampling method. Data were collected using the Fear of COVID-19 questionnaire, the Anxiety of COVID-19 questionnaire, and the Vijima Childbirth Experience questionnaire. Variables were described using descriptive indices and their analysis was done using a multiple linear regression model.

In this study, 135 participants (48.6%) had fear of COVID-19, and 126 (45.3%) had anxiety about COVID-19. Univariate analysis showed that the fear of COVID-19 had a significant relationship with the negative experience of childbirth (P-value<0.001), but the fear and anxiety of COVID-19 were not associated with neonatal outcomes. Multiple linear models show that the fear of COVID-19 has the greatest impact on the domain of lack of positive anticipation of childbirth experience (B=0.388).

Considering the fear and anxiety of COVID-19 are associated with a negative experience of childbirth, therefore, health policymakers should focus on appropriate solutions and interventions to reduce the fear and anxiety of this group of women in similar cases in the future.

The COVID-19 pandemic has changed the lives of many patients. Spiritual well-being in patients with type 2 diabetes and its relationship with quality of life, especially after controlling confounding factors, is an important aspect that needs more attention in specific populations. Therefore, this study aimed to determine the relationship between spiritual well-being and the quality of life in patients with type 2 diabetes.

This cross-sectional study was conducted in 2022. The samples included 177 patients with type 2 diabetes who were selected by convenience sampling from diabetes centers in Amol City. Data were collected using demographic information form, spiritual well-being, and quality of life questionnaires. Data were analyzed using descriptive and inferential statistics at the significance level of P<0.05.

The results of linear regression analysis to investigate the relationship between spiritual well-being and quality of life in patients with type 2 diabetes with controlling demographic and clinical variables, showed a positive correlation between the connection with life subscale and quality of life in patients with type 2 diabetes (β=0.49, P<0.001).

The findings suggest that after controlling for clinical and demographic confounding factors, spiritual well-being in patients with type 2 diabetes (especially in the existential health subscale) can predict their quality of life. Therefore, implementing interventions related to promoting spiritual well-being can provide a basis for a better quality of life in the post-COVID era.

Stress hyperglycemia is a neuroendocrine physiological response to medical stress, hyperglycemic stress increases the risk of mortality and morbidity in ill patients. This study aimed to investigate the frequency of hyperglycemic stress and its related factors, as well as the relationship between hyperglycemia and the severity and clinical outcomes of hospitalized patients with COVID-19.

This cross-sectional study was conducted in Imam Khomeini Hospital in Sari in 2019. The patients were diagnosed based on clinical symptoms, CBC, CRP, ESR tests, RT-PCR test, and CT scan of the lungs and were hospitalized in the Covid ward. Data analysis was performed using SPSS Software.

312 COVID-19 patients were investigated, and 22 (7.1%) suffered from hyperglycemic stress. Hyperglycemic stress patients had more mortality, hospitalization in ICU, respiratory ventilation, and length of hospital stay compared to the normoglycemic subjects, but only in terms of mortality, there was a statistically significant difference between the two groups (P=0.46)

Considering the effect of hyperglycemia on the outcome of the disease and the death rate in ill and hospitalized patients compared to patients with normal blood sugar, it shows the importance of timely diagnosis and proper control of blood sugar in these patients.

Urinary tract anomalies are responsible for urinary tract infection (UTI) in more than 30% of children. The present study was carried out to determine the prevalence of urinary tract anomalies in children with pyelonephritis referred to Amirkola Children Hospital during 2010-2020.

In this cross-sectional study, all children with UTI admitted to Amirkola Children Hospital during 2010-2020 were enrolled. The inclusion criteria were children aged between 2 months and 18 years, positive signs and symptoms of UTI, and positive urine culture with reliable sampling. Children with a positive history of surgery on the urinary tract were excluded. Imaging studies included ultrasonography, DMSA, DTPA, VCUG, RNC, and IVP for the diagnosis of anomalies in the urinary tract.

Among 381 children with pyelonephritis, the mean age was 37.1+41.3 months, and 337 (88.5%) children were girls. One hundred forty-nine (39.1%) children had urinary anomalies. The most anomalies were VUR, ureterovesical junction obstruction, Ureterocele, and ureteral duplication in 112(75.16%), 11(7.38%), 9(6.04%), and 8(5.36%) of children, respectively. A significant difference was observed between age and anomaly prevalence (P=0.04), but there was no significant difference between sex and prevalence of anomaly (P=0.3).

The results of the study showed that about 39% of children with UTI had urological anomalies, the most common cause of which was VUR, and other urological anomalies (about a quarter) such as ureterovesical junction obstruction, Ureterocele. In addition to vesicoureteral reflux, paying attention to other urological anomalies in these children is recommended

Fibromyalgia is a syndrome characterized by chronic musculoskeletal pain, tenderness, and other physical symptoms. We determined the frequency of Fibromyalgia in hypothyroid patients and the relationship between FM symptoms and hypothyroid status.

The current study is a cross-sectional descriptive study investigating the prevalence and demographic characteristics of fibromyalgia in hypothyroid patients referred to University clinic in Sari in 1401-1402. Ninety-one hypothyroid patients were included in the study. The sampling method was convenience sampling. The sociodemographic features and the clinical features of hypothyroid patients were recorded. Thyroid tests included T4, TSH, and Anti Tpo Ab. Patients were examined for Fibromyalgia using American College Rheumatology (ACR) criteria for FM 2010 and 1990. For the patients who were classified as FM, the FIQR questionnaire was completed. To analyze the data, descriptive statistics indicators such as central and dispersion indicators and calculation of ratios were used, and to check the relationship between qualitative variables, chi-square test and quantitative variable comparison in different groups were used by t-tests and ANOVA in SPSS-25 software was used.

The mean age and duration of hypothyroidism were 48.35 ± 13.8 and 9.84± 6.6 years respectively. The frequency of fibromyalgia in hypothyroid patients was 7(8%) patients based on ACR 2010 criteria. In patients with hypothyroidism and fibromyalgia, 6 patients (85.7%) were positive for Anti Tpo Ab, while in patients with hypothyroidism without fibromyalgia, 29 patients (34.5%) had this antibody (P=0.007).

It seems that Anti Tpo Ab is more important than thyroid dysfunction, and it is suggested to check this antibody in fibromyalgia patients in addition to thyroid function tests.

Pulmonary complications after surgery not only result in long-term hospitalization but also cause more complications and mortality. These complications can include atelectasis, pneumonia, bronchospasm, and even death. Measures to improve lung function include incentive spirometry, deep breathing exercises, etc. This research aimed to investigate the effect of incentive spirometry and deep breathing exercises on hemodynamic indicators (oxygen saturation level, PCO2, PH, blood pressure, heart rate) and pulmonary complications during and after gastric sleeve surgery.

Our study was an interventional one, participants were 75 patients who were referred to Imam Khomeini Hospital in Tehran in 2022 for sleeve operation. Using a simple random sampling method and block randomization and random numbers table, patients were divided into two intervention groups and one control group. Patients in the first intervention group used incentive spirometry two hours before the operation and two and six hours after the operation, and after the procedure, the patient's hemodynamic indicators were recorded by the researcher, the second intervention group used deep breathing exercises in the same order as the first group. and the hemodynamics of the patients were recorded in the same way. No special measures were taken in the control group. To check the effectiveness, the incidence of atelectasis and pneumonia (up to two weeks after the operation by referring to the patient's file and examination of clinical symptoms by an expert) and the length of stay of the patients in the hospital were checked.

Results showed that the use of incentive spirometry and deep breathing exercises in improving the oxygenation of patients undergoing sleeve surgery during and after the operation was not significant (P>0.05). No significant difference was found in the blood PH of the patients (P>0.05). Also, no significant difference was found in the heart rate of the patients during and after the operation (P>0.05). In the hemodynamic examinations, the blood pressure of the patients in these two intervention groups significantly improved compared to the control group (P<0.05). There was no significant difference in the rate of pulmonary complications after the operation among the three groups (P>0.05).

The use of incentive spirometry and deep breathing exercises improved the oxygenation and heart rate of patients undergoing gastric sleeve surgery before surgery, but they were not effective during and after the operation. They did not affect postoperative pulmonary complications and none of these two methods was superior to the other.

The prevalence of bacterial infections and the type of bacteria involved in causing endocarditis and knowing their antibiotic resistance pattern are very important for the correct selection of antibiotics to treat these infections and the proper control of infection in the hospital. In this retrospective cross-sectional descriptive study, we investigated the antibiotic resistance pattern of bacterial agents isolated from blood cultures of patients with infective endocarditis.

This retrospective study was conducted on patients with infective endocarditis admitted to Razi and Fatemeh Zahra teaching hospitals over the four years from 2019 to 2023. After collecting the data, it was entered into Excel software and then analyzed using SPSS version 19 software.

Among 28 patients included in the study, 57.1% were men and 42.9% were women; the median age of patients was 56.79±13.41 years. The most common isolated microorganism was Staphylococcus aureus with 11 positive samples (39.2%). Ninety-three percent of the studied microorganisms were resistant to at least two drugs. The result of the treatment was not significantly related to any of the gender, type of valve, and type of isolated microorganism (P=0.624, P=1.000 and P=0.398, respectively).

In this study, gram-positive bacteria were the most common group of microorganisms causing infective endocarditis. A high percentage of resistance was observed against some antibiotics including penicillin, ceftazidime, and ceftriaxone, which should be considered in initial empiric antibiotic therapy among hospitalized patients with infective endocarditis

A part of the expenses of every household in all societies of the world is health expenditures, which can sometimes be disastrous for families. This study was conducted to investigate the change in the share of health expenditure from the total Household costs in Mazandaran province and the possible impact of health system reforms on it in Iran during the recent two decades, especially the Health Transformation Plan.

This is a retrospective descriptive-analytical study, based on quantitative and secondary data. The data required for this study was taken from the Statistics Center including household income and expenditure for a period of 18 years from 2001 to 2018. Descriptive statistics indicators and trend charts were used to describe the quantitative data, and to analyze household health expenditures, the t-test was applied in SPSS software.

The results of the study showed that on average, the share of health expenditures in the total household expenses was 12.04% for urban households and 11.36% for rural households that is more than the stated and expected limit of 10%. The trend of changes in the percentage of health expenditures from the total household expenses at the time of the research compared to the base year has been variable and in some years it has decreased and in some years it has increased.

The health system reforms have not ultimately led to the reduction of household health expenditure to less than the expected level and its increasing trend in Mazandaran province.This means the risk of catastrophc health expenditure among households still exist. Even with the implementation of subsequent plans, the achievement of the previous plan has been neutralized. Considering the importance of financial issues in universal health coverage and also the limited resources of the health sector, more detailed policies and plans should be designed and implemented to target vulnerable groups so that families' financial hardship is prevented as well as the possibility of universal coverage is increased to the maximum.

Utilizing engaging techniques, such as animation, to educate adolescents about oral health can significantly impact their knowledge and behavior, resulting in the prevention of periodontal diseases. The current study aimed to compare the effectiveness of health education utilizing animation vs traditional education methods in improving adolescents' attitudes, behavior, and periodontal markers.

In this interventional study, 371 students aged 13 to 15 were randomly selected by cluster sampling and divided into two groups: control (187 students) and intervention (184 students). Questionnaires and clinical examinations of the Gingival Index (GI), Plaque Index (PI), and Sulcus Bleeding Index (SBI) were completed before and four weeks following the intervention, and the data were entered into the SPSS software (v. 23). The independent t-test and covariance analysis were used to analyze the data, and P<0.05 was considered significant.

After the intervention, the average scores of knowledge, behavior, GI, PI, and SBI indices were changed from 6.27, 5.90, 1.10, 0.85, and 0.31 to 7.53, 7.08, 0.73, 0.53, and 0.21, respectively. All indices in the control group also improved; however, after the intervention, a significant difference was recorded between the animation group and the control group in all indices, except health behavior (P<0.05).

Oral health education through animation is a novel and effective approach that can be more appealing to adolescents and beneficial in reducing periodontal diseases in young patients.

The nursing process is a framework in which nurses determine the abilities and problems of patients and develop methods for evaluating and planning nursing care programs. One of the challenges of nursing education is the use of methods to promote learning and creative thinking skills in learners. Therefore, this study was compiled to compare two methods of flipped classroom and conceptual map and flipped classroom and traditional method for the topic of nursing process on the variables of self-regulation learning strategies and satisfaction of nursing students.

This is an interventional study. The statistical population includes all nursing students of the first semester of Mehr (teaching using traditional and flipped classroom methods) and Bahman (teaching using flipped classroom method and conceptual map) of the year 2022 of Nasibah Sari School of Nursing and Midwifery. The study tool was a two-part questionnaire (demographic information, and learning strategies questionnaire). Visual Analog Scale (VAS: Visual Analog Scale) teaching method was used to check the level of students' satisfaction. In this study, the topic of the nursing process was selected from the nursing principles and skills course, the self-regulated learning strategies questionnaire was completed by the students once before and 4 weeks after teaching. Data entry and analysis were done using SPSS version 24 software.

There was no significant difference between students' satisfaction with the flipped classroom teaching method and the traditional method (8.54±1.38) with the flipped classroom teaching method and conceptual map (7.98±1.84) (P=0.124). The t-test showed that there was no significant difference in the average of self-regulated learning strategies after implementing the two teaching methods (P=0.258). The paired t-test showed that the comparison before and after the mean of self-regulation learning strategies in the flipped class group and the traditional method showed a significant difference (P=0.013).

The findings showed that despite the lack of statistical difference, students' satisfaction with the flipped classroom teaching method and the traditional method was higher. The average of self-regulation learning strategies in the flipped classroom and traditional method group was higher than the flipped classroom and conceptual map method group, and the previous comparison and then the mean of self-regulation learning strategies in the flipped class group and the traditional method showed a significant difference. It is suggested to conduct research with a larger sample size and in higher semesters

One of the factors influencing the quality of patient care and the desirable outcomes of nursing services is the mental workload; most individuals prefer specific coping strategies to reduce stress and mental workload in stressful situations. Coping strategies are a set of cognitive, emotional, and behavioral efforts to change stressful situations. The present study was conducted to determine the relationship between mental workload and coping strategies in nursing students at Mazandaran University of Medical Sciences in the year 2019.

In this descriptive-analytic cross-sectional study, 160 students were randomly selected from three nursing and midwifery faculties in Sari, Behshahr, and Amol. Data were collected using the NASA Task Load Index (NASA-TLX) mental workload questionnaire and the Lazarus and Folkman emotion-focused and problem-focused coping strategies questionnaire. The data were then analyzed using SPSS version 20.

A total of 88 females (55%) and 72 males (45%) with a mean age of 22.52±1.98 years participated in the study. Fifty-two (32.5%) used a problem-oriented strategy, and 96(60%) used an emotion-oriented strategy. The mental workload mean score was 72.80±14.55 and a statistically significant relationship was found between mental workload with age and physical demand subscale (P=0.032 and p=0.028, respectively). No statistically significant difference was observed between the mental workload and coping strategy in both genders (P=0.171 and P=0.397, respectively). Moreover, no significant association was found between the mental workload and the overall coping strategy score (P=0.066).

Nursing students had high scores for mental workload, which can negatively impact the quality of care provided by them. Additionally, the most frequently used coping strategy among these students was emotion-focused coping. The use of problem-focused coping strategies reduces emotional distress, decreases mental workload, and enhances individuals' efficiency. Considering the obtained results, there is a need to develop and provide appropriate solutions in the field of education, focusing on problem- focused coping strategies rather than emotion-focused strategies, to increase the efficiency of students.

Due to the high spread of the coronavirus and the mode of transmission through touching contaminated surfaces and then touching the eyes, nose, or mouth, health workers have the highest risk of contamination, and vaccination of this workforce is necessary to reduce the risk, but this vaccination also resulted in high and common side effects such as local, systemic, early and late side effects. Therefore, the present study was conducted to investigate the early and late complications caused by the booster dose of the AstraZeneca vaccine in the personnel and medical staff of Razi Ghaemshahr Medical Training Center.

This descriptive cross-sectional study was conducted on all personnel and treatment staff of Razi Ghaemshahr Center in 1400. Participants were selected by convenience sampling method and a questionnaire related to the topical and specialized questions about booster vaccine side effects was used to collect the data. The data were analyzed using chi-square test and two-way logistic regression.

302 health workers who received a booster dose of the AstraZeneca vaccine participated in this study. The participants had an average age of 34.89, 37.7% were men and 62.3% were women. The most common side effects of the vaccine include pain 64.2%, fatigue 58% and fever 54.6%. The participants were monitored for two months in terms of late complications, including heart attack, stroke, and pulmonary embolism after injecting a booster dose of AstraZeneca, and there were no reports of late complications.

According to the results of this research, due to the possibility of more systemic side effects such as muscle pain, fatigue, cough, and fever after the injection, healthcare personnel should pay special attention to the early side effects of the vaccine.

Zinc transporter autoantibody 8 (ZnT8A) was recently identified as a novel antibody antigen in type 1 diabetes mellitus, and its positivity is associated with early onset of the disease. So the present study was conducted to determine the prevalence of autoantibodies related to type 1 diabetes mellitus, especially ZnT8A as a newer antibody in children from 1 to 18 years of age referred to Amirkola Children's Hospital.

In this descriptive and analytical study, 80 children under 18 years of age with type 1 diabetes referred to Amirkola Children's Hospital, Babol, Iran during the years 2013 to 2021 were included in the study. Pediatric diabetes was diagnosed based on the criteria of the American Diabetes Association and with a visit to a pediatric endocrinologist. Antibodies related to type 1 diabetes including 65 glutamic decarboxylase (anti-GAD), protein tyrosine phosphatase (IA-2A), anti-islet cell autoantibodies (ICA), insulin autoantibodies (IAA), and zinc transporter 8 (ZnT8A) was measured from their blood samples at the time of disease diagnosis by ELISA method. Data were analyzed using t-test, chi-square, and Fisher's exact test. The significance level in this study was considered as p<0.05.

Samples were 80 children with an average age of 7.9±3.6 years (57% girls and 43% boys). The level of GADA in the studied samples was 65.2%, IA-2A 58.8%, ZnT8A 56.3%, ICA 47.5%, and IAA 6.3%.

93.8% of diabetic patients were autoantibody positive, which shows that by measuring the level of pancreatic antibodies, type 1 diabetes is confirmed in more than 90% of patients. Also, by measuring newer antibodies such as ZnT8A, the percentage of idiopathic type 1 diabetes cases also decreases.

Hydrogels have unique properties such as water retainer, softness, flexibility, and biocompatibility that cause their application in biology. Among the various hydrogel structures can be referred to intelligent hydrogels. These structures can respond to environmental stimuli. Environmental stimuli can be physical, including temperature or chemicals, such as pH. In this study, the application of smart hydrogels in the fields of medicine, protein, and gene delivery, as well as tissue engineering has been divided and the results of this study show that different types of smart hydrogels with different capabilities have been identified. The mechanical strength of hydrogels is suitable for physiological function and various purposes such as biomedical applications, tendon and ligament repair, cartilage replacement, and tissue engineering. Currently, hydrogels are used to make contact lenses, health products, tissue engineering scaffolds, drug delivery systems, and wound dressing. Most studies in the field of smart drug delivery have been reported, especially in anticancer drugs, and also tissue engineering that can achieve more desirable results in the near future.