مجله دانشگاه علوم پزشکی مازندران
پیاپی 243 (فروردین 1404)

Background and purpose:

 Spinal cord injuries are usually severe and currently lack effective treatment. Bone marrow stem cells (BMSCs) have significant potential for repair by reducing inflammation, regulating immunity, stimulating angiogenesis, promoting growth, and enhancing cell differentiation. They are promising for treating these injuries by supporting nerve axon growth and myelin regeneration. This study examines the role of BMSCs in addressing the challenges of spinal cord tissue repair.

BMSCs were isolated from the femurs of 150–200 g rats, and after culturing, the third passage was used. Thirty Wistar rats (200–300 g) were divided into three groups: control, lesion control, and BMSC-treated. Spinal cord injury was induced by dropping a 10 g weight on the T13–L1 region. On the eighth day after injury, either a vehicle solution or 1 million BMSCs in 10 μL were injected into the injury site. Evaluations, including the BBB test, hot water withdrawal latency, nerve conduction velocity, LFB staining, and GAP-43 protein expression, were performed using the western blot method.

Treatment with BMSCs significantly increased the BBB score, improving hind limb movement in rats. These cells also reduced the reaction time for paw withdrawal and enhanced sensory system function. Furthermore, BMSCs significantly reduced spinal reflex latency and accelerated the compound action potential (CAP) recorded in the gastrocnemius muscle. Moreover, they promoted axon growth and proliferation by increasing GAP-43 protein expression and contributed to improved myelination.

The results indicate that the use of BMSCs as a therapeutic approach reduces axon and myelin degeneration while promoting neuronal growth and repair. These reparative effects at the molecular level were associated with increased GAP-43 protein expression and improved sensory and motor function in the hind limbs of animals.

Kidney stones are a prevalent disease with a high recurrence rate. This study aimed to investigate the efficacy of Tribulus terrestris, α-pinene, and boron, both individually and in combination, in treatment and improvement of kidney stones in an animal model.

In this experimental study, 1.0%(v/v) ethylene glycol was added to the drinking water of rats for 28 days to induce kidney stones.The animals were divided into six groups
(n = 6): control group, ethylene glycol group, and four treatment groups that received ethylene glycol for 2 weeks, followed by ethylene glycol plus α-pinene (10 mg/kg), boron (15 mg/kg), Tribulus terrestris (60 mg/kg), or a combination of all three (same doses), administered daily by gavage from the second week until the end of the study. Biochemical parameters in plasma (creatinine, Ca, P, uric acid) and kidney tissue (Ca, phosphate, and oxalate) and histological evaluations were assessed. Data were analyzed with GraphPad Software. Comparisons were performed using one-way ANOVA and the Bonferroni test.

The results indicated that in the ethylene glycol group, serum levels of creatinine, urea, uric acid, phosphorus, and calcium were elevated, and there was also an increase in calcium, phosphate, and oxalate levels in kidney homogenates, suggesting kidney damage. In the treatment groups, the aforementioned blood markers were reduced, indicating effective treatment. Histopathological analysis revealed kidney deposits in the ethylene glycol group, whereas the treatment groups showed a reduction in kidney deposits.

The results of this study indicate that Tribulus terrestris, α-pinene, and boron are effective in management of kidney stones. Moreover, the combination of these three compounds exhibited an improved effect. Results demonstrated that the group receiving all three treatments exhibited the greatest reduction in calcium oxalate crystals. Subsequently, the groups treated with α-pinene and boron, followed by those treated with Tribulus terrestris, showed progressively decreasing effects.

Given the important role that heterocyclic compounds play in the pharmaceutical and medical industries; it is essential to understand their unique properties. In particular, the presence of two heterocyclic rings in these compounds enhances their biological activity and makes them valuable in various therapeutic applications. Numerous studies have shown that heterocyclic compounds derived from pyrimidine and pyrrole exhibit various biological activities, including antimicrobial, antifungal, antiviral, and antitumor properties. Therefore, this study aims to evaluate the antimicrobial and anticancer effects of synthetic compounds on several Gram-positive and Gram-negative bacteria, as well as normal and cancerous breast cell lines, in vitro.

In this experimental study, ten derivatives of dihydropyrimidine compounds attached to pyrrole were synthesized. The antibacterial activity of these compounds was evaluated against Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Bacillus subtilis, and compared with gentamicin and ciprofloxacin. Their anticancer activity was assessed in a breast cancer cell line, compared with doxorubicin, at 48 and 72 hours using an MTT assay to determine cytotoxicity.

Among these compounds, compound 4e, which contains chlorine, exhibited the highest antimicrobial effect, with MIC= 3.90 μg/ml and MBC= 7.81 μg/ml, compared to gentamicin, which had MIC= 0.031 μg/ml and MBC= 0.125 μg/ml. Also, compound 4e demonstrated the highest inhibitory effect, with IC₅₀= 0.16 ± 0.009 μM, compared to doxorubicin (IC₅₀= 3.42 ± 0.10 μM), which was used as the reference drug after 48 hours.

The results of this research demonstrated the effectiveness of synthetic compounds against Gram-positive bacteria and cancer cells. These findings suggest that these compounds shave the potential to serve as effective antimicrobial and anticancer agents.

Background and purpose

Aging is a complex process characterized by multiple cellular and molecular disorders, gradually leading to a decline in physiological and cognitive functions. In this context, the prevalence of obesity, a key factor that exacerbates these issues, is increasing. This study aimed to examine the impact of a combined exercise intervention on interleukin-10 levels, vascular endothelial growth factor (VEGF), the neutrophil-to-lymphocyte ratio, cognitive performance, and gait performance in obese elderly men.

This randomized clinical trial (IRCT20200509047372N1) included 40 obese elderly men (mean age: 61.90± 2.84 years; BMI: 31.01 ± 1.53 kg/m²), who were randomly assigned to either an intervention group (n= 20) or a control group (n= 20). The intervention group participated in a combined exercise regimen for 16 weeks, with three sessions per week, each lasting 90 minutes. Plasma levels of interleukin-10, VEGF, and the neutrophil-to-lymphocyte ratio, as well as cognitive and gait performance, were measured 48 hours before and after the intervention. Data normality was assessed using the Shapiro-Wilk test, and statistical analysis was performed using paired t-tests and ANCOVA at a significance level of 0.05, with SPSS version 26.

The findings indicated that the combined exercise intervention significantly improved cognitive and gait performance in the experimental group (P= 0.001). Additionally, interleukin-10 and VEGF levels increased significantly in the experimental group (P=0.001). However, no significant differences were observed in BMI or weight between the two groups (P> 0.05). Similarly, no significant changes were found in the neutrophil-to-lymphocyte ratio in either group (P > 0.05).

These findings suggest that combined exercise may enhance cognitive and gait performance while increasing interleukin-10 and VEGF levels in obese elderly men. However, this exercise intensity did not significantly affect the neutrophil-to-lymphocyte ratio.

(Clinical Trials Registry Number: IRCT20200509047372N1)

Sleep quality and overall quality of life are key factors in improving the health and well-being of the elderly. Given the preference for non-pharmacological methods, this study examines the effects of sleep hygiene training and reflexology massage on sleep quality and the quality of life among the elderly.

This randomized controlled trial, conducted in 2023, included 127 elderly individuals in Sari. Participants were divided into three groups: two intervention groups and one control group. The intervention groups received either sleep hygiene training (delivered in small groups of 2–5 participants) or black seed oil massage (administered in 8 sessions over 4 weeks). The control group received no intervention. Sleep quality and quality of life were assessed at three time points: before the intervention, immediately after, and one-month post-intervention, using standardized questionnaires. Data were analyzed using repeated measures analysis, Tamhane post-hoc tests, and generalized estimating equation tests.

Before the intervention, there was no significant difference in sleep quality between the groups (P = 0.763). However, post-intervention and one month later, significant improvements in sleep quality were observed in both intervention groups (P= 0.001). Similarly, quality of life was significantly higher in both intervention groups compared to the control group (P= 0.05). No significant difference in quality of life was found between the intervention groups immediately after and one-month post-intervention (P= 0.525).

These results indicate that non-pharmacological methods, such as sleep hygiene training and foot reflexology massage, can significantly improve both sleep quality and quality of life in the elderly. Based on the findings, both methods are recommended, with foot reflexology massage showing greater effectiveness. It should be considered as a primary approach to enhancing sleep quality and overall well-being in the elderly.

Understanding the factors influencing nurse retention and developing effective strategies to address the ongoing nursing shortage is crucial. Therefore, this study aimed to examine the intention to remain among critical care unit nurses and the factors associated with it in the medical education centers of Mazandaran University of Medical Sciences in 2023.

This descriptive-analytical study included 365 nurses from the intensive care units of the medical education centers at Mazandaran University of Medical Sciences. The inclusion criteria were a bachelor's degree or higher in nursing, no self-declared history of mental disorders, and at least one year of experience working in an intensive care unit. Data were collected using a demographic information checklist and a questionnaire on the determinants of nurses' intention to stay in the hospital, designed by M. Satoh et al. Statistical analysis was performed using SPSS version 24.

A total of 365 nurses with an average age of 34.97± 7.21 years participated in this study. Among the individual factors, age (OR=0.29), gender (OR=1.81), marital status (OR=6.88), and among the occupational factors of the workplace department (OR=7.17), the employment status (OR=2.19), interest and attachment to the nursing profession (OR=1.65) and also the workplace hospital (OR=3.43-6.43) were the most important factors affecting the retention rate of nurses working in the critical care unit.

The findings indicated that among individual factors, age, gender, and marital status, and among occupational factors, the department and hospital of employment, employment status, and interest and attachment to the profession were the most important factors influencing the retention rate of nurses working in the intensive care unit.

The transition of hospitals from non-teaching to teaching institutions has been increasing in recent years. This study aimed to investigate the key processes involved in this transition.

This research was conducted using a mixed-methods qualitative approach. The first step involveddocument analysis, the multiple voting technique, and scenario and process development. The second step employed a comparative qualitative study using data extraction tables.

In the first step, 195 processes were identified, and after prioritization, 19 were selected. Then, 67 documents were reviewed to categorize the content related to each type of hospital. Workstations and flowcharts were compared, leading to the identification and mapping of seven new processes introduced by the addition of the teaching mission, as well as the strengthening of 12 existing processes. The changes include the involvement of new personnel in activities, an increase in the number of process steps and processes, and a greater number of individuals responsible for executing these steps. Also, the complexity of teaching processes increases due to clinical training, requiring the simultaneous presence of students and medical staff.

Considering the involvement of new personnel and the changes in the number and variety of responsible individuals, special attention should be given to employee resistance, potential conflicts, and both individual and group communication. The doubling and prolonging of processes require careful consideration of hospital performance, patient satisfaction, and the clinical training of future healthcare professionals. The simultaneous presence of students and medical staff highlights the need for increased supervision and attention to patient safety and quality. Two key processes from the total reviewed processes are related to patient acceptance and assignment, making it crucial to focus on these as the first point of contact and key communication channels for providing services and preventing quality and performance gaps, based on the findings of this study.

One of the challenges in the treatment of gout is patient adherence to prescribed therapy. The aim of this study was to investigate the frequency and factors influencing the discontinuation of uric acid-lowering treatment in gout patients during 2023-2024.

This study is a descriptive cross-sectional analysis conducted on 100 gout patients who visited clinics in Sari between 2023 and 2024. Demographic information, underlying conditions, and gout-related details, as well as the history of drug discontinuation during the course of the disease and in the past year, were reviewed. Adherence to treatment was defined as regular drug use for more than 80% of the days in the year. Descriptive and analytical statistics were performed using SPSS software, with the T-test and Chi-square test applied. A p-value of ≤ 0.05 was considered statistically significant.

The mean age of the patients was 51.09 ± 15.5 years, and the mean duration of gout was 6.38± 8.1 years. Fifty-six patients had underlying conditions, and 41 patients had a history of kidney stones, either past or current. Fifty-three patients had discontinued one or both medications at some point during the course of their disease. Medication discontinuations in the previous year included anti-inflammatory drugs in 34 cases, uric acid-lowering drugs in 36 cases, and both drugs in 30 cases. The most common reason for medication discontinuation was the patient's perception of lack of necessity for the medication. The number of attacks was higher in the group with treatment discontinuation (P = 0.01)

More than half of the patients discontinued medications during the course of the disease, and the adherence rate to uric acid-lowering medications over the past year was 64%. Physicians should place greater emphasis on ensuring the appropriate use of medications to effectively improve treatment adherence.

Hypoxia can lead to impairments in body function and is linked to the pathology of acute mountain sickness, cardiovascular disease, and stroke, all of which are leading causes of death in many countries. Silybum marianum is a plant known for its strong antioxidant properties. This research aims to investigate the anti-hypoxic effects of S. marianum and its major constituent, silymarin, in three experimental models of hypoxia in mice.

The protective effects of the methanolic extract of S. marianum aerial parts and silymarin against hypoxia-induced lethality in mice were evaluated using three experimental models of hypoxia: asphyctic, haemic, and circulatory. In the asphyctic hypoxic model, phenytoin (50 mg/kg, i.p.) was used as the positive control, while in the haemic and circulatory models, propranolol (20 and 30 mg/kg, i.p.) served as the positive control. Normal saline (0.5 ml, i.p.) was used as the negative control. Analysis of variance (ANOVA), followed by Newman-Keuls multiple comparisons (performed using GraphPad Prism 8), was used to determine significant differences in means.

The extract and silymarin exhibited significant protective effects by increasing the survival time of male mice, even at their lowest doses, across all tested models. Silymarin was effective in all models and demonstrated a comparable effect to propranolol and phenytoin, which were used as positive controls. Except in the asphyctic model, the extract at a dose of 62.5 mg/kg exhibited the same activity as silymarin at 12.5 mg/kg.

The presence of silymarin in the extract may be responsible for the antihypoxic activities observed in the plant extract. Both the methanolic extract and silymarin, when tested separately, demonstrated significant protective effects against hypoxia in all tested models, exhibiting similar activity to the positive controls.

Metabolic syndrome is considered a prognostic indicator of fatal diseases, such as cardiovascular disease and diabetes. The present study aimed to investigate the prevalence of metabolic syndrome and its associated factors among middle-aged individuals in Qaemshahr, Iran in 2023.

In this descriptive analytical cross-sectional study, 900 individuals aged 30-59 who visited the health centers in Qaemshahr were included. Metabolic syndrome was defined based on the NCEP-ATP III criteria. The data analysis was conducted using SPSS version 23. The comparison of quantitative variables was performed using the student’s t-test, while qualitative variables were compared using the Chi-square test.

Thirty-four percent of the studied population suffers from metabolic syndrome. Among individuals with metabolic syndrome, 38.9% had impaired systolic blood pressure, and 28.1% had impaired diastolic blood pressure. The majority of individuals with metabolic syndrome (94.7%) had triglyceride levels between 150 and 199 mg/dL, which were classified as borderline. Also, 5.23% of individuals had high triglyceride levels. Impaired HDL was observed in 80% of women and 55.3% of men with metabolic syndrome. There was a positive and significant relationship between age, systolic blood pressure, diastolic blood pressure, waist circumference, height, weight, HDL, FBS, triglycerides, and waist circumference-to-height ratio with metabolic syndrome (P< 0.05).

This study showed that 34% of the studied population suffers from metabolic syndrome, with middle-aged women being at higher risk than men. Therefore, primary prevention should address not only biological risk factors but also individual social and lifestyle conditions. In this regard, a basic organizational framework is suggested to identify affected individuals, ensure continuous follow-up, and provide education.

The postpartum period predisposes women to a variety of mental health problems, one of which is postpartum depression, a common and serious condition affecting 8% to 26% of women worldwide. It is also recognized as a major public health concern. One potential cause of postpartum depression is exposure to stressful events before birth. Evidence suggests that continuous maternal support during labor may help reduce the incidence of this condition. Therefore, this study aimed to compare the prevalence of postpartum depression between women who received continuous support during labor and those who did not in Bandar Abbas in 2016.

In this prospective, descriptive-analytical study, 220 postpartum women were divided into two groups: one receiving continuous support from a doula (including emotional, physical, and informational support) and the other receiving no doula support (routine care). Participants were observed and assessed at the maternity ward of Bandar Abbas Social Security Hospital from August 2016 to January 2017. Data were collected using a demographic questionnaire and the Edinburgh Postnatal Depression Scale (EPDS), administered eight weeks postpartum. The results were compared between the two groups. Statistical analysis was conducted using SPSS (version 20), employing the independent t-test, Chi-square test, Mann-Whitney test, and two-way logistic regression.

There was a statistically significant difference in the prevalence of postpartum depression between the two groups (P<0.001). After adjusting for other variables, a significant association was found between postpartum depression and doula support (P< 0.001, OR= 0.17). The odds of developing postpartum depression were reduced by 83% among mothers who received doula support.

The findings of this study indicate that continuous doula support during labor significantly reduces the risk of postpartum depression.

The radicular cyst is the most common dental cyst, often asymptomatic, and primarily observed in men in their 30s and 40s, particularly in the anterior maxilla. If left untreated, complications such as tooth displacement and swelling may occur. Treatment options for this cyst include enucleation, marsupialization, or a combination of both. This disorder is more common in males and typically affects the anterior region, particularly the maxilla. A 12-year-old girl presented with jaw swelling and delayed eruption of permanent mandibular teeth. The patient reported a history of jaw trauma at the age of 4. On intraoral examination, swelling was observed on the left side of the mandible in the edentulus space of teeth 31–35, extending from the ridge level to a depth of 5 mm in the labial vestibule. The surface of the swelling was smooth and pink, matching the color of the healthy mucosa, with a firm consistency. The lesion measured approximately 1 × 3 cm. A cyst with hyperplastic follicles and phantom teeth was observed in the panoramic radiograph. This report presents a rare case of a radicular cyst associated with regional odontodysplasia. Early diagnosis and appropriate management of such cysts in children, particularly when permanent teeth are affected, are essential to ensure optimal functional and developmental outcomes.