مجله دانشگاه علوم پزشکی مازندران
پیاپی 229 (بهمن 1402)

The evidence indicates that exercise training can affect the heart's structure at the cellular-molecular levels. Therefore, this study aimed to investigate the effect of exercise training on miR-222 and the expression of cTnT, Cx43 genes, and cardiomyocyte proliferation in pre-pubertal, young adult, and old male rats.

The number of 30 male Wistar rats in three age groups; 2 weeks as the pre-pubertal group, 8 weeks as the young group, and 96 weeks as the old group were randomly divided into two training groups (n=5), and control (n=5). Resistance training programs (resistance ladder, 3 days per week) and aerobic (treadmill running, 3 days per week) were performed for 6 weeks. The expression of miR-222 and Cx43, cTnT, and Ki67 genes were investigated by the Real Time-PCR method. One-way analysis of variance and Tukey's post hoc test were used (P≥0.05).

The amount of BrdU protein by immunohistochemical method and Ki67 gene expression was significantly higher in the training groups than in the control groups in all three age groups: pre-pubertal, young adult, and old male rats (P≥0.05). miR-222 was significantly higher in the group of trained pre-pubertal than in the control group (P=0.023). The increase in cTnT gene expression in the pre-pubertal groups (P=0.018) and old rats (P=0.015) and the increase in Cx43 gene expression in the old rats group (P=0.009) was observed.

Aerobic-resistance training can be an effective stimulus to increase cardiomyocyte proliferation in all three age groups pre-pubertal, young, and old.

Today, the use of medicinal plants such as T. daenensis as a complementary and effective treatment method to control and inhibit the growth of pathogenic microorganisms is increasing all over the world. This study aimed to investigate the antimicrobial effects of T. daenensis essential oil (EO) and its nanocapsulated against some pathogenic bacteria isolated from aquatic and food samples.

In this experimental research, T. daenensis was collected in June 2023 in Shahrekord City. The EO of the dried aerial part of the plant was obtained by using a Clevenger device (steam distillation). The components in the EO were identified by gas chromatography-mass spectrometry (GC-Mass). T. daenensis EO nanocapsules were prepared using Tween 20, Tween 80 as emulsifier, polyethylene glycol as a co-solvent, acidic chitosan solution (1%), and modified starch (5%) as a coating. Transmission electron microscope (TEM) and dynamic light scattering (DLS) were used to confirm their structure. Antimicrobial properties against Listeria monocytogenes, Escherichia coli, Bacillus cereus, Salmonella typhimurium, Proteus mirabilis, Staphylococcus aureus and Klebsiella pneumoniae isolated from aquatic samples (fish and lobster) and various foods (raw milk, traditional ice cream and mutton, beef, chicken) were investigated by disc diffusion method, determination of minimum inhibitory concentration (MIC) and bactericidal (MBC) by microdilution method. Also, the prevention of biofilm formation was investigated.

The main components of the T. daenensis EO were thymol (75.31 percent), 8 p-Cymene (4.62 percent), carvacrol (4.2 percent), trans-cayophyllene (3.01 percent), terpenine (2.01 percent) and beta- myrcin (1.21 percent), respectively. TEM and DLS methods confirmed the structure of the T. daenensis EO nanocapsules. The size of nanocapsules was between 50 and 90 nm. The MIC amounts for the mentioned bacteria were between 62.5 and 250 μg/ml. The lowest MIC value for P. mirabilis, S. aureus, and K. pneumoniae was reported with a concentration of 62.5 μg/ml of T. daenensis EO nanocapsule. Also, the amounts of MBC for the mentioned bacteria were between 125 and 1000 µg/ml. According to the obtained results, the MIC and MBC levels for all mentioned bacteria against T. daenensis EO nanocapsule were lower than the EO alone (P<0.05). According to the results, with the increase in the concentration of EO, the diameter of the non-growth halo increased, while these results were not the same for T. daenensis EO nanocapsule. In all bacteria except S. aureus, the diameter of the non-growth halo for different concentrations of EO was greater than that of T. daenensis EO nanocapsule. The inhibition percentage of biofilm production was also reported 100% at 125 and 250 μg/ml of T. daenensis EO nanocapsule, except for K. pneumonia. In all concentrations of T. daenensis EO nanocapsule, the percentage of bacteria biofilm reduction was significantly higher than the EO alone (P<0.05).

Based on the findings of the study, the T. daenensis EO nanocapsule had more antibacterial properties than EO alone. It is suggested that future studies for the toxicology of T. daenensis EO nanocapsule on normal and cancerous cells be done iv-vitro. In addition, to apply it in the food industry, experimental studies on food models should also be conducted

Ischemic heart disease (IHD) is a major public health problem and in 2019 it was the leading cause of years of life lost due to premature death. Knowing its incidence and mortality rates can help in designing and implementing preventive interventions in different regions of the country. In this study, the incidence and mortality pattern of IHD during the years 1990-2019 was investigated in the provinces of Iran.

In the current ecology study (ethics code IR.ZUMS.REC.1402.216), age-standardized incidence and mortality rate (per 100,000 population) of ischemic heart disease for 31 provinces of Iran from the Global Burden of Disease Database (GBD) in 1990, 1995, 2000, 2005, 2010, 2015 and 2019 were extracted. Also, the incidence and mortality rates in the age groups below 44, 45-54, 55-64, 65-74, 75-84, and above 85 years in the studied years were investigated. In men and women, in different age groups and overall, the mortality-incidence ratio (MIR) was also calculated. To identify provinces with similar trends in incidence, mortality, and MIR in the studied years, model-based clustering analysis was used. A finite mixture of multivariate t-distributions was used in the clustering method. Bayesian Information Criterion (BIC) was used to determine the number of clusters (number of different trends). To determine the number of clusters, different clusters were considered and BIC was calculated. The number of clusters with the lowest BIC value was considered as the final number of clusters in each index. Analyzes were performed in R 4.2.0 software.

During the years 1990 to 2019, the incidence rate of IHD in women has decreased by 6% and men by 4%, the mortality rate of IHD in women by 35% and men by 40%, and MIR in women by 69% and men by 62%. The results showed that from 1990 to 2019, in Khorasan Razavi province, we saw a 13% decrease in the total incidence of the disease, and in Ardabil province, we saw only a 1% decrease in the total incidence of the disease. The lowest rate of IHD in 2019 was in Tehran province. Also, in both genders, Tehran province had the lowest mortality rate and the lowest MIR. North Khorasan province has the highest incidence and Golestan province has the highest mortality rate and the highest MIR of the disease in 2019. Based on the results of clustering analysis, the incidence rate is 3, the mortality rate is 2 and MIR has 2 trends (clusters) in 31 provinces. The IHD incidence rate in Ardabil, Golestan, South Khorasan, Qazvin, Qom, Sistan, and Baluchistan, Tehran, and Yazd, the mortality rate in Ardabil, Bushehr, Chaharmahal and Bakhtiari, Hormozgan, Ilam, Kurdistan, Lorestan, Qazvin and Semnan, and MIR in West and East Azerbaijan, Bushehr, Chaharmahal and Bakhtiari, Fars, Gilan, Golestan, Hormozgan, Ilam, Isfahan, Kerman, Kermanshah, Khorasan Razavi, Khuzestan, Kurdistan, Lorestan, Markazi, Mazandaran, Semnan and Yazd had a similar trend and a higher value than other provinces.

The incidence and mortality rate and MIR have decreased during the 30 years of study in Iran, but this decrease in the incidence rate was less than the decrease in the other two indices. This shows the need for health system planners to pay attention and focus on first-level preventive programs. Also, the observed difference in incidence and mortality rate according to different provinces, and planning according to different regions is noted.

Due to the significant increase antibiotic-resistant bacteria, this study aimed to determine the frequency of bacteria causing respiratory, blood, and wound infections in patients admitted to the Rouhani Medical Center in Babol and to determine their antibiotic resistance pattern.

This study was carried out on 267 isolates collected from 158 blood samples, 60 respiratory samples, and 49 wound samples prepared from patients referred to Rouhani Hospital in 2022. The bacteria detected by the hospital laboratory were transferred to Mazandaran University of Medical Sciences and confirmed in the microbiology laboratory of the Faculty of Medicine. Then, the antibiotic susceptibility pattern of the isolates was analyzed by the disk agar diffusion method and interpreted according to the guidelines of the Institute of Clinical and Laboratory Standards. The results were analyzed using SPSS-19 statistical software.

The highest prevalence of bacteria isolated in this study (20.59%) was related to Escherichia coli and the lowest prevalence (1.12%) was related to Proteus mirabilis. Among 158 strains isolated from blood samples, E. coli (26.58%) was the most common bacteria. Among the 60 isolates collected from respiratory samples, Acinetobacter baumannii (23.33%) was the most prevalent and among the 49 strains isolated from wound samples, Staphylococcus aureus (30.61%) was the most common bacteria identified in this study. The antibiotic resistance pattern of the gram-positive bacteria identified in this study showed that the highest resistance (78.43%) of S. aureus strains was against tetracycline, while 3.92% of the isolates were resistant to linezolid. The resistance of coagulase-negative staphylococci and Enterococcus faecalis to the tested antibiotics varied between 12.5% and 83.33%. The amount of antibiotic resistance of Gram-negative isolates identified in this study also varied between 12.5% and 75.47%. The antibiotic resistance of S. aureus isolated from blood, respiratory, and wound samples to the tested antibiotics was 3.57% to 85.71%, 25% to 62.5%, and 25% to 62.5%, respectively, while tetracycline and linezolid were the least and most effective drugs against this bacterium. Among the gram-negative bacteria isolated from blood, respiratory, and wound samples, 34.51% to 61.94%, 41.66% to 64.58%, and 41.66% to 64.58% of the isolates were resistant to tested antibiotics, respectively, while piperacillin and imipenem were the least and most effective drugs.

The emergence of resistant strains in hospitals is related to continuous contact with all kinds of antibiotics, and the implementation of exact care strategies can lead to the prevention of drug resistance and spread. The most important factors to achieve these goals are the exact control of hospital care, prevention of hospital infections, and compliance with the principles of antibiotic use. Therefore, the essential role of infection control methods in hospitals, avoiding the unnecessary prescription of antibiotics, especially in surgical prophylaxis, proper isolation of patients, and appropriate use of laboratory facilities for the rapid diagnosis of microorganisms in each hospital is emphasized. The diagnosis and report of the antibiotic resistance pattern of common organisms in the region can be considered in empirical treatments to prevent the emergence of antibiotic resistance and high treatment costs for patients and medical centers.

Thalassemia is a common disorder in Iran and the world. The progress in the field of diagnosis and treatment of thalassemia made these people able to live for a longer period. In these patients, frequent blood transfusions are associated with numerous complications such as depression, anxiety, stress, etc. These problems are associated with a decrease in the quality of life. Therefore, this study was carried out to investigate and compare the quality of life in beta-thalassemia major patients with and without blood transfusion.

In this study, which was cross-sectional and descriptive-analytical in nature, a total of 170 patients with thalassemia major, aged 18-60, who were referred to the Thalassemia Center of Bo Ali Sina Hospital in Sari during the summer of 2014, were examined. The study was conducted with the ethical code IR.MAZUMS.REC.1402.18665 of Mazandaran University of Medical Sciences. According to the inclusion criteria, education level, and age range of the studied population, 116 patients out of 170 thalassemia major patients were studied. Considering that the number of thalassemia major patients with and without blood transfusions referring to the thalassemia center of Bo Ali Sina Hospital in Sari is almost equal, out of 116 patients with inclusion criteria, 58 patients are treated with periodic blood transfusions and 58 patients are under control without the need for transfusions. Blood was studied. Thalassemia patients are treated with blood transfusion every 15-30 days for injection and patients who do not need blood transfusion every 1-3 months to the thalassemia center for control. SF 36 standard questionnaire was used to check the quality of life. The reliability and validity of the Persian questionnaire were reported with Cronbach's alpha coefficient of 0.77 to 0.90 and vitality scale of 0.65. To analyze the variables, frequency indices, percentages, independent t-test, and chi-square test were used.

Among the thalassemia major patients studied, 52 (44.8%) were male and 64 (55.1%) were female. The average age in the group with and without blood transfusion was 34.75±8.35 and 39.33±8.18 years, respectively. There was no statistically significant difference in the average age between the two groups (P=0.128). There was no significant difference in the marital status, occupation, and level of education between the patients with and without thalassemia major injection. Among the investigated clinical complications, diabetes was significantly higher in the blood transfusion group (P=0.001). From the average coefficients of the eight indices of the SF 36 test, the subscale of general health (GH) was significantly better in patients with blood transfusion with a mean and standard deviation of 55.79±19.20 than in the non-injection group, 44.05±21.59 (P=0.002).

It is suggested that in patients with thalassemia, especially thalassemia major, with or without blood transfusion, like other periodical control measures and medical treatment, evaluation of general health and quality of life should be carried out at regular intervals, to improve the quality of life of these patients, timely psychological or psychiatric interventions to be done at the required time.

Scholarship is an integral aspect of academia, educational scholarship is the kind of outstanding scientific activity and innovation in the fields of discovery, education, application of original research results, and integration of information obtained from different components of a field or different scientific fields. The identification of  the strategies for the development of educational research in the faculty members of the universities can provide a suitable background for the excellence and growth of the medical universities, considering that in the search made in the sources, there are evidences of monitoring the presentation of the solutions. And we did not find the challenges of developing educational research, this study was conducted to investigate and analyze the challenges and solutions of developing educational research from the perspective of the academic staff of Mazandaran University of Medical Sciences.

The current research was a qualitative and content analysis type of research. The samples of this study were selected purposefully. The samples included academic faculty members who have innovative educational processes and academic faculty members who participated in scholarship workshops and developed innovative educational processes but did not develop a process. The collection of information continued until the collected data was a repetition of the previous data so that no new information was found and data saturation took place. For data collection, semi-structured interview with a focused group discussion method were used, and for data analysis, the conventional content analysis method was used.

After merging the codes extracted from two focus group discussion sessions and repeated revisions, 75 codes were finally identified. Then, these codes were classified into 14 categories, which include educational leadership and management, inappropriate policies, empowerment, financial resources, material and spiritual support, information resources, supportive educational environment, group and teamwork, publishing results, creating a culture of innovation, and identifying needs. Education, change management, mentoring, and interdisciplinary convergence. Finally, the first 6 categories below were placed under the theme of challenges and the other 8 categories were placed under the theme of solutions.

The results of this study showed that from the point of view of university faculty members, the most important challenges in the development of educational scholarship are the difficulty of developing educational processes, the high score of research activities compared to research activities, the alienation of academic staff members from research and educational processes, and the most important solutions for the development of scholarship; The promotion of interprofessional cooperation for the formulation of educational processes, the use of change management for the development of scholarship activities, the development of group activities for Scholarship activities in educational groups.

Covid-19 is the name of the disease caused by the new SARS-Cov-2 virus. Thus far, numerous non-specific therapies have been employed for this viral infection, however, the majority of these medications have proven to be ineffective and have been correlated with a multitude of adverse effects for patients. Therefore, the use of medicinal plants has received a lot of attention. The current study aims to investigate the effects of the supplemental drug Curcumex on the healing process in outpatients with COVID-19.

The present study, which is a double-blind randomized controlled clinical trial, was conducted on outpatients with covid-19 which has the code of ethics number IR.MAZUMS.REC.1400.593 from Mazandaran University of Medical Sciences. The inclusion criteria for this study include patients who had a ground glass appearance in the CT scan of the chest, the presence of clinical symptoms such as dry cough, shortness of breath, fever, weakness, diarrhea, headache, runny nose, or having a history of contact with a corona patient or recent travel to High-risk areas and people who had a positive PCR result in the nasopharyngeal swab were defined. Curcumex is a new herbal medicine that contains a combination of black pepper, turmeric, and ginger. Black pepper is hot in nature and has astringent, anti-bloating, and digestive properties. Antioxidant and anti-inflammatory effects have been reported for this plant, which can be useful in COVID-19 disease. The sample size was equal to 60 people who were divided into 2 intervention and control groups of 30 people. Both groups received routine medications prescribed for outpatients. In addition to these treatments, one group received curcumex (containing 170 mg of ginger, 4 mg of black pepper, and 340 mg of turmeric) daily, and the control group received a placebo.

The results of the current study indicated that the average duration of all clinical symptoms measured in this study was significantly less in the intervention group than in the control group (shortness of breath: 2.13 days vs. 3.66 days; cough: 4 days vs. 7.6 days; Gastrointestinal symptoms: 0.73 days vs. 2.21 days and myalgia: 4.1 days vs. 9.2 days). Also, these results show that the average body temperature before the start of the intervention in the intervention group was 38.32 degrees Celsius and 38.17 degrees Celsius in the control group. This rate 5 day after the start of the study in the intervention group was significantly lower than the control group (37.46 degrees Celsius vs. 37.92). The average oxygen saturation before the intervention was 94.76% in the intervention group and 95.63% in the control group. This amount 5 day after the start of the study in the intervention group was significantly higher than the control group (97.16% vs. 96.1%) (Table 2). to the control group. The results of this study showed that the average number of lymphocytes after the intervention in the intervention group increased significantly compared to the control group (1544.46 in the intervention group and 1132.58 in the control group).

This study showed that daily consumption of Curcumex drug as a supplement along with other routine treatments of COVID-19 disease has a positive effect on the recovery process of the disease shortens the course of clinical symptoms, reduces inflammatory markers by a quarter, and corrects lymphopenia. The duration of clinical symptoms, including shortness of breath, cough, myalgia, and gastrointestinal symptoms in patients with COVID-19 who have been treated with Curcomex has significantly decreased. Furthermore, these results indicated that the recovery of fever and hypoxemia (decreased hemoglobin oxygen saturation) in the intervention group was faster than the placebo group and was significantly less than the group of patients who received a placebo.

Chronic abdominal pain or recurrent abdominal pain is defined as abdominal pain that occurs in at least three episodes, lasting for a minimum of three consecutive months, and is severe enough to adversely affect the child's normal functioning. Abdominal pain can be a challenging complaint for many specialists because, at the same time, it can indicate a completely benign finding, it can also indicate the presence of an acute and malignant pathology. At this stage, the most important action of the treating physician is to diagnose the disease as organic or functional. The present study was conducted to evaluate the diagnostic performance of upper gastrointestinal endoscopy in diagnosing organic causes of chronic abdominal pain in children and investigating the correlation between clinical symptoms and pathological findings of endoscopy in children aged 3 to 12 years with chronic abdominal pain. 

The present study was conducted as a cross-sectional study on 100 children with chronic abdominal pain without pathological cause who visited the pediatric clinic of Ayatollah Mousavi Hospital in Zanjan, from April to December 2021. At first, after taking the initial history and examining the clinical symptoms of the patient, diagnostic and paraclinical tests were performed to determine the cause of chronic abdominal pain. If the cause of the pain was diagnosed using clinical and paraclinical examinations, the patient was excluded from the study and treated accordingly. Then, the children who could not find a specific cause for their pain were referred to a pediatric gastroenterology specialist for endoscopy. After a complete examination and observation of the upper gastrointestinal tract, a pathology sample was also prepared for all patients, and endoscopic, pathological, demographic, and clinical findings were recorded for all patients. Finally, the data was statistically analyzed by SPSS version 26 software using Chi-2 statistical tests, Fisher's exact test, t-test, and Mann-Whitney.

The mean ± standard deviation of the children's age was 8±2.66 years. 63% of the children were girls and 37% were boys. The most common complaints in children after abdominal pain were vomiting (19%) nausea (14%) and non-response to outpatient treatment (8%). The most common accompanying symptoms besides abdominal pain included nausea, vomiting, tooth decay, and constipation. Endoscopic findings were normal in only two patients with abdominal pain, and in 98% there was at least one organic lesion. The most common findings in pathology examination were GERD I at 48%, Small sliding hiatal hernia at 37%, and GERD II at 24% respectively.

Our findings indicated that most cases of chronic abdominal pain in children had an organic origin, and it was better to conduct further investigations to identify the cause of the pain. The most common pathological findings in these children were GERD I, II, and sliding hiatal hernia. Clinical manifestations of the disease, diverse clinical symptoms, paraclinical findings, initial tests, and mucosal biopsy results can help diagnose the cause of chronic pain. By finding the cause of the pain, effective actions can be taken to control the pain of these children

Cesarean hemorrhage is a common but preventable cause of maternal death and placenta invasion is a major cause of cesarean hemorrhage. This study aimed to compare inhalation anesthesia with isoflurane and Propofol anesthesia in cesarean bleeding in these patients.

This study was conducted as a randomized clinical trial with 15 placental adhesion patients who were candidates for cesarean section. Five patients were excluded by applying the exclusion criteria, and out of the other 10 patients, 5 underwent cesarean section with isoflurane and 5 with Propofol.

The comparison indicated that the volume of suctioned blood, the number of gasses used, the volume of serum received, packed-cell received and urinary output were significantly lower in the Propofol group (P≤0.05). Systolic and diastolic blood pressures were significantly close to basic figures in the Propofol group (P≤0.05), Heart rate, respiratory rate, temperature, and O2 saturation were not significantly different between the two groups (P≥0.05).

The findings of this study recommended propofol anesthesia for the cesarian section in placenta adhesion. However, further studies with more cases are needed.

Vaccination is a highly effective medical intervention in the COVID-19 pandemic. Systemic Capillary Leakage Syndrome (SCLS) is a severe and rare condition that can occur following COVID-19 vaccination, leading to recurrent shock episodes in patients. This report highlights a case where a patient experienced leakage syndrome after receiving the AstraZeneca vaccine. The 31-year-old female patient experienced shortness of breath, blood pressure drops, edema, and limb coldness 48 hours after receiving the COVID-19 vaccine. The clinical assessments identified low blood pressure, rapid heart rate, and reduced breath sounds at the bases of the lungs. Bilateral pleural effusion was observed in a chest CT scan, and pericardial effusion of moderate severity was seen in echocardiography. Laboratory tests showed leukocytosis, hyponatremia, hypoalbuminemia, hypocalcemia, and transudative pleural fluid. The remaining observations fell within standard parameters. Measures such as fluid restriction, correction of electrolyte imbalances, prescription of corticosteroids, and antibiotic therapy were applied. These interventions resulted in an improvement in the patient's overall condition, leading to the resolution of her symptoms. Since the symptoms of leakage syndrome are non-specific, and its diagnosis is based on excluding other causes, and considering that no paraneoplastic evidence was found in the studied patient, the diagnosis of leakage syndrome was attributed to the individual.For individuals exhibiting hypovolemic shock and edema linked to pleural effusion or ascites, and upon excluding conditions such as nephrotic syndrome, hypercoagulability syndromes, sepsis, and connective tissue vascular diseases, attention should be directed towards the possibility of leakage syndrome. Supportive care is the mainstay of treatment in these patients, and fluid restriction is a key component of management. Awareness of the symptoms and signs of this syndrome, as well as factors that may trigger its recurrence, is essential for physicians to make appropriate decisions for timely diagnosis and treatment in similar cases

Lipid accumulation in the liver is associated with non-alcoholic fatty liver disease (NAFLD), with obesity and insulin resistance being the main contributing factors. The AMPK/SIRT1 signaling pathway plays a crucial role in addressing lipid metabolism issues. Recent studies have demonstrated that the AMPK/SIRT1 signaling axis is involved in preventing and reducing liver damage. Upregulation of AMPK/SIRT1 can regulate lipid metabolism and oxidation in liver cells. In NAFLD, increased activity of AMPK/SIRT1 can inhibit the synthesis of fatty acids and cholesterol by down-regulating adipogenesis genes (FAS, SREBP-1c, ACC, and HMGCR). Therefore, activation of the AMPK/SIRT1 signaling pathway represents a potential therapeutic target for liver disorders. This review summarizes the most recent studies on the AMPK/SIRT1 pathway signaling axis and the mechanisms of herbal activators of the AMPK/SIRT1 pathway in non-alcoholic fatty liver