مجله دانشگاه علوم پزشکی مازندران
پیاپی 122 (اسفند 1393)

Background and Solubility behavior of a drug is one of the key determinants of its oral bioavailability. The bioavailability maybe enhanced by increasing the solubility and dissolution rate of drug by incorporation the drug in a hydrophilic carrier. Piroxicam is a poor water soluble، non-steroidal analgesic and anti- inflammatory drug. The purpose of this study was to prepare and determine the piroxicam solid dispersion characteristics to alter its solubility. Piroxicam solid dispersions were prepared by hot melting and melting–solvent methods using PEG4000. The influence of tween 40 was also studied. The prepared solid dispersion properties of the drug were evaluated by dissolution studies، Differential scanning calorimetry (DSC)، Fourier–transform infrared spectroscopy (FTIR)، and X-ray powder diffraction (XRD). The results showed a significant increase in dissolution rate of piroxicam from solid dispersions. Tween 40 also increased the dissolution rate of solid dispersions. XRD patterns indicated that piroxicam exists in its solid state in all solid dispersions. The DSC and FTIR results showed no chemical interaction between the drug and the polymer. This study showed significant improvements in dissolution rate of piroxicam solid dispersion prepared by PEG4000 and tween 40.

Background and Hospitalized patients experience at least one hospital-acquired infection. Antibiotics are usual drugs used in such conditions that impose high cost burdens on patients and community. Moreover, they cause bacterial resistances. The purpose of this study was to evaluate the usage of antibiotics in intensive care unit in a teaching hospital. A cross sectional study was conducted within six months in 101 critically ill patients who were on antibiotics in intensive care unit in Sari Bouali Sina Hospital. The patients’ and antibiotics’ information were recorded and then analyzed. Among the samples 23.8% were not sent for bacteria cultures. In 58.4% there were negative cultures. Bacteria were detected in 41.6% and the comments were E. coli 24.4%, Klebsiella 17.1%, and Acinetobacter 9.8%. The most commonly used first-line antibiotics in hospital were ceftriaxone (72.3%) and meropenem (10.9%), while in second-line treatment meropenem was given more often. Suitable sampling, identifying the bacterial species, and selecting an appropriate antibiotic are of great importance in successful treatment of infections. Irrational use of antibiotics could lead to false negative results, and thereby bacterial resistances.

Background and Respiratory failures are common diseases among different populations. Pneumocystis jirovecii colonization causes respiratory failure in children and adults with AIDS and patients with predisposing factors of immunosuppression including malignancies, organ transplant, inherited immune deficiencies and immunosuppressive agents. The aim of this study was to evaluate the efficacy of three staining methods including Calcofluor White, Giemsa and Gomori Methenamine Silver in identification of Pneumosystis colonization using Bronchoalveolar lavage (BAL). The study population included 350 patients with respiratory failure who referred to Tehran Shariati Hospital and Sari Imam Khomeini Hospital during August 2013 to September 2014. Totally, 322 BAL samples, 26 induced sputa and 2 samples of sinus washing were evaluated for Pneumocystis jirovecii colonization after staining with the three specific staining methods. Data was then analyzed in SPSS V.16. The patients were 41.2% female and 58.8% male. The mean age of patients was 52 ± 4 years. Calcofluor White staining showed Pneumocystis jirovecii colonization in three patients (0.86%). In this study, Calcofluor White staining presented higher efficacy in identifying Pneumocystis jirovecii in BAL samples compared to other two microscopic procedures.

Background and Infant mortality rate (IMR) is one of the most important indices and a human development index (HDI). This study was designed to estimate the IMR, under-five mortality rate (U5MR), life expectancy (LE) at birth in Iran and 31 provinces and to compare the results in five-year intervals using 2006 and 2011 census data. In a cross-sectional study we used Cole-Demeny West (CD West) model using indirect method to estimate the childhood mortality rates, life expectancy at birth, number of children ever born (CEB) and children surviving (CS) rat. The analyses were performed in QFive program of MORTPAK 4.3 software. IMR, U5MR, mortality rate in children aged 1- 4 and LE at birth for 2006 census were estimated to be 47.3, 14.5, 61.2 per 1000 live births and 64.4 years, respectively. Whereas, for 2011 census, they were calculated 21.9, 4.1, 25.9 per 1000 live births and 72.1 years, respectively. The maximum IMR and U5MR for 2011 were calculated in Sistan and Baloochestan (31.8, 38.8), Southern Khorasan (30.9, 37.7) and Semnan (29.9, 36.3) per 1000 live births. The minimum IMR and U5MR for 2011 were observed in Qom (13.5, 15.6), Mazandaran (13.8, 16) and Tehran (15.8, 18.4) per 1000 live births. The results indicate childhood mortality rates have declined dramatically during the five-year interval. In addition, ranking the provinces in terms of childhood mortality rates and LE can be used in detecting provinces poor in reproductive and child health and finally pave the way for adapting long- term health strategies.

Background and Drug supply system is one of the most important parts of every healthcare system. Logical prescription and rational use of drugs are important factors that guarantee health in the society. According to official reports, every Iranian consumes 442 drugs per year, amongst which a considerable number is not prescribed by physicians. Emergence of microbial resistances, adverse drug reactions and increasing burden of unnecessary health care spending are due to irrational use of drugs. This study aimed at investigating the consumption and prescription of drugs in Mazandaran Province in inpatient and outpatient settings. In an experimental study, 23 governmental hospitals and 11 private and Social Security hospitals were chosen by Health Information System (HIS). Then a list of top-selling drugs (2013-2014) and their prices in outpatient settings was obtained. The information of outpatient settings was also collected by Noskhe Pardaz software. Data was then analyzed and compared with the reports provided by Medscape. In the top-selling list of the inpatient settings, there were twenty drugs (all in injection form), of which, seven were antibiotics. Also, expensive drugs such as Albumin, Vial Pantoprazole and IVIG were amongst the nine highly consumed drugs. In outpatient settings, injectable form of Dexamethasone was found prescribed more than other drugs in Mazandaran. High numbers of antibiotics and injectable drugs used for inpatients and outpatients in Mazandaran province calls for more focused attention on consumption and prescription of drugs.

Background and Mindfulness has an important role in variables associated with depression. This study aimed at investigating the efficacy of Mindfulness-Based Stress Reduction (MBSR) on cognitive emotional regulation strategies in women with major depression (MDD). A Quasi-experimental study with Pre-test/Post-test and follow-up design was performed in 2013. Thirty MDD patients were selected and randomly assigned into experimental and control groups. The experimental group received Mindfulness-Based Stress Reduction, while the control group did not receive any psychological treatment. Cognitive emotion regulation questionnaire (Garnefski, 2007) was used to collect the data. Data were analyzed using covariance analysis and repeated measure. After treatment, scores of patients who received MBSR showed decrease in maladaptive Cognitive Emotion Regulation strategies (self-blaming, rumination, catastrophizing and other-blames); and in some adaptive cognitive emotion regulation strategies (positive reappraisal) an increase was observed. Also, the changes in three-month follow up were persistent. Mindfulness-Based Stress Reduction could be used as an appropriate choice for treatment via direct targeting of mechanisms of change in cognitive emotion regulation strategies, and help in relapse prevention of major depression disorder.

Background and Nosocomial infections are among the main causes of death among hospitalized patients. Successful control of these infections requires awareness on their prevalence and taking preventive measures in hospitals. This study aimed at determining the prevalence of hospital-acquired infections in Mazandaran province. A descriptive-longitudinal study was performed in 15 hospitals in Mazandaran province that record their infection rates in NISS software. Data was analyzed at the significance level of 0.05 using SPSS and STATA software. To investigate the relationships between different variables crosstabs and Poisson regression were applied. The mean ages of infected male and female were 54.53±0.67 and 49.2±0.63 years, respectively (P<0.05). In 2011 there were 342 cases per 10,000 while in 2012 a total of 6825 per 10,000 was recorded. The highest prevalence of infections was due to pneumonia, urinary infection, surgical incisions, and burn wounds. The majority of infections were caused by Escherichia coli (E. coli) (12.3%), Pseudomonas aeruginosa (6.3%), Acinetobacter (6.1%), and Klebsiella (5.9%). A significant relationship was observed between an underlying disease and various types of infections (P<0.05). The risk of hospital infections in women was 1.09 times more than men (P=0.918). The difference observed between current findings is probably due to lack of precise recording of the infected patients in hospitals. Therefore, it is necessary to hold training programs throughout the province, so that nurses become more familiar with NISS software.

Background and Fasciola hepatica and Fasciola gigantica are common liver flukes that are the etiological agents of fasciolosis, which affects both domestic livestock and humans worldwide. In the present study we established a rapid, easy and also accurate tool, for differentiation between F. hepatica and F. gigantica using Fast PCR. Thirty adults of Fasciola species were isolated from sheep and cattle liver form abattoirs in Mazandaran province. ITS1 rDNA region were amplified by Sapphire Amp® Fast PCR and compared with AccuPower® Taq PCR PreMix from Bioneer. In addition, PCR-RFLP assay using Tsp509I was performed for identification of F. hepatica and F. gigantica. A fragment of approximately 463bp was amplified in all of the Fasciola samples using Sapphire Amp® Fast PCR premix in just 34 minutes, while nucleic acid amplification was completed in about 1 hour and 46 minutes by Bioneer PCR master mix. All PCR products were digested with restriction enzyme TasІ (Tsp509I). After digestion, F. hepatica revealed two fragments of 151 and 312 bp while F. gigantica produced three fragments of 93, 151, and 219 bp. Fast PCR reaction using Sapphire Amp® Fast PCR premix was completed three times faster than the time of conventional premix. The new Fast PCR assay using Sapphire Amp® Fast PCR premix provides a simple, rapid and accurate technique for identification and differentiation of Fasciola species in epidemiological researches on human and domestic animals in endemic regions of fasciolosis.

Background and Gastroesophageal reflux is the most common disease of the digestive tract which could have adverse effects on mental health and quality of life. Unfortunately, there is an increasing incidence of this disease in Iran. In this study we examined the relationship between mental health and quality of life in people with acid reflux disease in general population in Amol, 2012. This cross sectional study included 473 people who were randomly selected via cluster sampling. Among the subjects 229 had gastroesophageal reflux disease while 224 people did not suffer from the disease. The questionnaires for demographic characteristics, mental health and quality of life and reflux were completed. To analyze the data t test, chi-square and Spearman correlation were applied. Patients with reflux had lower scores in mental health status. Also, eight domains of quality of life in people with gastroesophageal reflux disease was lower for the domains of physical role, body pain, general health perception, vitality, social functioning, and mental health. In this study we found that mental health in people with gastroesophageal reflux is lower than that of the normal subjects. Also, the quality of life in these people, especially in six domains of physical role, body pain, general health perception, vitality, social functioning and mental health, was lower than those of the healthy people.

Background and In MRI the concentration of contrast agent is indirectly measured from signal intensity (SI). It is important to find the maximum linear relationship between SI and concentration of the iron oxide nanoparticles for perfusion measurement. The aim of this study was to investigate the effect of inversion time on SI and the maximum linear relationship between SI and concentration of the polyethylene glycol (PEG) coated iron oxide nanoparticles at different inversion times (TIs) using inversion recovery pulse sequence in T1-weighted MR images. A phantom was designed to hold the vials with different concentrations of the PEG coated iron oxide nanoparticles in MRI coil. MR imaging was performed using inversion recovery Turbo-FLASH sequence with different TIs. The maximum SI and the maximum linear relationship between SI and concentration of the nanoparticles were measured at different TIs. The maximum SI and the maximum linear relationship between SI and nanoparticles’ concentration were dependent on TI. The maximum SI at different TIs was seen at the highest concentration (500µmolFe/L). The maximum SI which led to a linear relationship with the nanoparticles concentration (R2=0.99) was obtained up to 105.49 and 243.64µmolFe/L for TIs of 400 and 240ms, respectively. TI has an effect on strength of SI in MRI. Increasing the TI values leads to a decrease in concentration of the PEG coated iron oxide nanoparticles that gives the maximum linear SI.

Background and Cyclophosphamide (CP) is a current chemotherapeutic drug which negatively influences the structure of testis. This study aimed to evaluate the protective effects of Imedeen on histological structure of seminiferous tubules and testosterone in CP treated adult mice. In this experimental study, 60 mature male mice were assigned to six groups (n= 10 per group).The animals in control group received normal saline, while in other groups the animals were treated with CP 12mg/kg/day, Imedeen in single dose 111µg/kg/day, Imedeen in two dosage 222 µg/kg/day, CP and Imedeen in one dosage, and CP and Imedeen in two dosage, respectively. After 35 days the animals were sacrificed. Histological and histomorphometrical analysis of testis was performed. Serum levels of testosterone were also evaluated. In CP treated group the histological study of testis confirmed that the percentage of seminiferous tubules with positive tubular differentiation (37.97±2.97), repopulation index (18.50±0.64) and spermatogenesis index (43.74±2.2) were significantly (P<0.05) lower than the control and Imedeen treated groups, while Imedeen diminished the adverse effects of CP (p<0.05). These results support the idea that CP can damage the testicular tissue but Imedeen could effectively prevent these adverse effects by inhibiting oxidative processes.

Background and Enterococci are important agents of endocarditis and urinary tract infections. They acquire resistance against antimicrobial agents which causes difficulty in their treatment. This study aimed to determine the antimicrobial susceptibility of strains resistant to vancomycin and identification of resistance genes vanA and vanB Enterococcus strains isolated from teaching hospitals in 2014. Hundred and fifty isolates of Enterococcus were isolated from hospitals and the genus and species composition were identified using different biochemical methods. Antibiogram tests were also conducted. The minimum inhibitory concentration was conducted applying broth micro dilution. Finally the strains containing vanA and VanB genes were identified. The antibiogram test showed 10 strains with VanA and VanB phenotype. All strains were resistant to ciprofloxacin. VanA and VanB genes were detected in all 10 isolates of vanA phenotype and two strains of vanB phenotype. VanA and VanB genes were proliferated by PCR in two strains of the10 strains that were VanA phenotype. Among Enterococcus species E. faecium and E. faecalis isolates were detected in teaching hospitals. The highest rate of resistance was to erythromycin and tetracycline and the lowest resistance rate was to vancomycin.

Background and A common question of patients with dyslipidemia is to know the priority of nutrients intake in their daily regimen. To make decision about the best diet and recommend it to patients, the physicians and/or nutritionists should consider a lot of factors. In a cross sectional study, a self-administered questionnaire was used that contained a list of health factors related to dyslipidemia. A number of internal doctors and nutritionists in three different universities of Mashhad, Tehran and Kerman filled the questionnaires. The opinions of respondents about each factor were collected using Visual Analogue Scale. Data was analyzed applying Fuzzification, Alpha Cut Set and Fuzzy Triangular Membership Function. The exact amounts resulted from Analytic Hierarchy Process (AHP) were replaced by the amounts resulted from Fuzzy AHP (FAHP) and the weight of each factor was calculated separately and in group by Microsoft Excel® and MATLAB®. The most important factors according to respondents were: Body Mass Index (BMI), level of serum LDL, the pattern of daily repast, level of serum cholesterol and having uncontrolled diabetes mellitus. The findings of this study and the method of setting priorities for nutritional regimen could be used as a practical guideline for nutritionists when recommending daily regimen for dyslipidemia patients and providing better consultations.

Background and In ischemic state some substrates are shifted to glucose leading to less oxygen consumption. The aim of this study was to assess the effect of glucose, insulin and potassium (GIK) infusion in patients with high risk acute coronary syndrome (ACS). A double-blind, pilot clinical trial was conducted in 41 high-risk ACS-NSTEMI-patients attending Emergency Department in the first 12h of showing symptoms. They were randomly assigned to receive either GIK (n=20) or conventional treatment (n=21). We recorded the patients’ demographic information, serum troponin level and Electrocardiogram (ECG) findings in admission and 24 hours later, and 30-day mortality rate. The mean age of patients was 61.46±12.13 years and there were 21 (51.2%) male. There was no significant difference between two groups in age, gender, history of underlying diseases and lab data (P>0.05). ECG changes showed improvements among 9 patients in GIK group (50%) and 7 patients in control group (33.3%) (P=0.55). The mean changes of troponin level in GIK and control groups were 1.01±2.03 and 1.87±4.40, respectively. The 30-day mortality rate was zero. This study showed no significant difference in efficacy of high dose GIK on ECG changes, serum troponin level and one-month mortality rate after treatment.

Background and Transesophageal echocardiography (TEE) is established as a sensitive and accurate diagnostic method for the rapid assessment of cardiovascular diseases. It is believed that dexmedetomidine might be useful for sedating patients undergoing TEE. This study compared the use of dexmedetomidine and midazolam in patients undergoing TEE. In a clinical trial, 48 patients undergoing TEE were randomly divided to receive either dexmedetomidine 1µg kg/i.v. over 10 min, followed by 0.2µg kg/i.v infusion, or midazolam 2 mg/i.v. Patients’ sedation level was determined according to Ramsay Sedation Scale, degree of analgesia, patient's satisfaction, arterial pressure, heart rate (HR) and readiness for discharge from recovery room. Degree of analgesia, in the group receiving dexmedetomidine was found higher compared with that of the midazolam group (3.67±0.86 vs 0.83±0.56, P<0.001). The level of patients satisfaction with sedation was also higher in dexmedetomidine group (P=0.001). Readiness for discharge in the two groups were 7.08±1.17 and 3.71±1.57 min, respectively (P=0.001). Blood pressure and heart rate were similar in both groups. Our study suggests that compared to midazolam, dexmedetomidine is more suitable in sedation of patients undergoing TEE.

Background and Appropriate and efficient disinfection is an important aspect of hospital infections control. The aim of this study was to investigate the effects of common disinfectants used for Escherichia coli bacteria separated from two teaching hospitals in Sari, 2014. Escherichia coli were taken from different wards in Zare and BouAli hospitals. E.Coli was identified by standard plant methods, differential test and biochemical isolation. Deconex plus53, Creolin and Cidex were used as disinfectants in various concentrations. Their effects were determined by Standard disc diffusion method. Data was analyzed using regression in Minitab V.17. A total of 120 samples were investigated of which 48 (40%) were found contaminated and 15 (13%) of these isolates were positive for E.coli. The most effective disinfectants against E.coli were Cidex 2%, deconex Plus53 2%, and Creolin 3.5%, respectively. Performing pretests is necessary for choosing the most appropriate disinfectant and increasing its efficacy. Also, it is important to consider common infectious bacteria in hospitals and effective factors on disinfectants such as concentration and time.

Background and Phenol and its derivatives are used as raw material in many chemical, pharmaceutical and petrochemical industries. It is classified as priority pollutant, due to its high toxicity. In this study, the magnetic activated carbon nano-composite was used for quick removal of phenol. The activated carbon was modified by magnetic nano-particles. Then physical properties of the adsorbent were investigated using BET, XRD and SEM. Afterwards, adsorption behavior of phenol onto the adsorbent was studied considering various parameters such as: pH, phenol concentration, contact time and adsorbent dosage. Also, the isotherms and adsorption kinetics model was studied. BET analysis showed 10.25% decrease in the specific area of activated carbon after being amended by the Fe3O4 nano-particles. SEM and XRD confirmed the presence of Fe3O4 nano-particles on the activated carbon. Optimum absorption points in this process were pH=8, contact time of 15 min and adsorbent dose 2g/L. The Longmuir isotherm and pseudo-second-order kinetics were fitted to the data. The maximum adsorption capacity of phenol on AC_Fe3O4 was 84.033 mg/g. Creating magnetic properties on the activated carbon which has a high adsorption capacity of phenol could result in quick separation of phenol from aqueous solutions. Also, this adsorbent could be widely applied since it is inexpensive and simple to use.

Background and Suitable workload of nurses is one of the main factors in patient care safety and quality assurance. Thus, measuring nurse's workload in ICUs is really important. The aim of this study was to determine the degree of nursing workload in ICU and associated factors using Nursing Activity Scale (NAS). A descriptive-analytical study was performed in 285 ICU inpatients in educational Hospitals affiliated to Mazandaran University of Medical Sciences. The patient's demographic data and medical data were collected through a checklist during three months. NAS was applied to evaluate the nursing workload. The sample consisted of 162 (56.8%) male and 123(43.2%) female. The mean age of patients was 42 ± 4.2. Among the subjects 164 (57.5%) had medication and 121(42.5%) were on surgical treatments. Most of the patients (48.4%) were admitted from operating rooms. The mean scores of NAS were 121.56 ± 40.49, 105.95 ± 34.98, and 99.57 ± 26.07, in morning, afternoon and evening shifts, respectively. The study showed a high degree of nursing workload in ICU in three working shifts. Using NAS is recommended for determining the ratio of the nurse's activities to their numbers in order to provide high quality patient care in ICUs via allocating adequate number of nursing staff.

Background and Cesarean delivery on maternal request is so common in Tehran, Iran. Behavioral beliefs have an important role in the intention of selective cesarean and could influence the choices for educational training. The aim of this study was to determine the behavioral beliefs about cesarean section based on Theory of Planned Behavior (TPB) in pregnant women. A qualitative study with purposive sampling was designed in which data was collected through in-depth interviews. The interviews were recorded and then transcribed. Content analysis was performed in which exploratory interviews were performed according to the principles of TPB. Afterwards, the information was coded and each interview was analyzed. A total of 36 women (mean age 27.8 + 4.5) was interviewed. Two main themes were extracted from the interviews: positive and negative beliefs about cesarean section. Then four sub themes were explored including long term and short term complications, and long term and short term advantages of cesarean section. In this study women had both true and false beliefs about caesarean section. Thus, health care providers should be aware of misunderstandings about caesarean section among pregnant women.

Background and Natural Organic Matter (NOM) is precursor of disinfection by-products (DBPs) during chlorination, so removal of NOM from drinking water resources is a necessary task. Due to organophilic properties, Surfactant Modified Zeolite (SMZ) can adsorb more NOM. The aim of this study was to determine and compare the efficiency of NZ and SMZ in removal of Dissolved Organic Carbon (DOC) from water. Modification of zeolite was performed using Alkyl Dimethyl Benzyl Ammonium Chloride (ADBAC) as organophilic compound. Natural zeolite was added to 10% concentration of ADBAC solutions, then, the mixture was shaken for 24 h. Modified zeolite was washed several times with distilled water. Solutions containing various concentration of natural organic matter were contacted with NZ and SMZ for 48 h. The effects of parameters such as initial DOC concentration, solution pH and adsorbent dose were examined. Measurement of dissolved organic matter was performed by TOC (Shimadzu-5000) analyzer. By increasing the sorbent dose, the amount of adsorbed DOC was increased. In the natural pH condition, the amount of DOC adsorption by 20 gL-1 of NZ and SMZ was 33% and 65%, respectively. By increasing the concentration of DOC the adsorption capacity increased. The best fitted model for NZ and SMZ were Freundlich and Langmuir, respectively. Cationic surfactant modified zeolite could increase the adsorption of DOC from water.

Background and Borna disease virus (BDV) is a unique RNA virus with wide range of hosts. There are many similarities in behavioral disorders caused by BDV in animals and certain mental disorders in human which suggests possible etiology of these disorders. The purpose of this study was to investigate the relationship between BDV and etiopathogenesis of psychiatric disorders, particularly schizophrenia and its prevalence in this group of patients. RNA was extracted from blood cell of 30 patients with schizophrenia and 15 healthy volunteers. It was screened for a 391-nucleotide, highly conserved region of the p24 and 447-nucleotideregion of the p40 of BDV, using specific primers and nested RT-PCR. The mean age of the patients and controls were 36.03 ± 11.28 and 31.86 ± 10.61 years, respectively. BDV RNA was detected in eight patients with schizophrenia, while none of the healthy subjects was found infected with BDV. The prevalence of BDV virus was significantly higher in people with schizophrenia (26.66%) compared to that of the control group (P< 0.05). This study supports previous findings regarding the relationship between BDV and psychiatric disorders, especially schizophrenia. Therefore, this virus could be considered as an environmental factor that can increase the risk of mental illnesses in adults.

Background and Rabies is a viral disease that is usually transferred to humans through the bites of infected animals (especially dogs). Difficult treatment and painful death in all patients makes it a major public health concern. There are some interesting points about the rabies in Traditional Medicine resources, especially in Persian Medicine. In this study the book entitled Tebbe Akbari was used as an invaluable source of Persian Traditional Medicine which is a complete and practical collection about many diseases. The information about rabies was extracted from the book. Also, the latest version of National Guidelines for Rabies Control was used. Data from both sources were compared with each other including etiology, symptoms, diagnosis, and treatment. Almost all points about rabies in Tebbe Akbari were found similar to the national guidelines recommended for rabies control. However, recent improvements in treatment, especially vaccination and microscopic methods in diagnosis of the disease have led to stop using traditional diagnostic methods. Probably more knowledge and awareness about traditional medicine books and performing evidence based studies could help in finding more simple and less expensive diagnostic methods.

Background and Traumatic brain injuries (TBIs) are the most common types of accidents and a leading cause of death in victims. This study aimed to evaluate the attendance rate for traumatic brain injury among patients who referred to Sari Imam Khomeini Hospital 2013 - 2014. In a descriptive study 1304 patients with head injury attending the hospital were studied. A questionnaire was completed for each patient considering demographic characteristics, time of injury, GCS, brain CT scan findings, and associated injuries. Data was then analyzed in SPSS V. 17. The majority of victims aged 20 to 30 years of old (29.6 %) and most of them were male (9.67%). Traffic accidents were the main cause of trauma (75.2%) of which most occurred with motor cycle (40%). Winter was the most eventful season (36.9%) and most of the injuries occurred between the hours of 1800 and 2400 (48%). Most injuries were associated with trauma to the face (3.2%). Brain CT scan was found normal in 33.1%. The most common abnormal brain CT scan was skull fracture (18%). Among the subjects 8.7% had severe brain injury and death occurred in 4.1% while hemorrhage was the main cause (2.5%). The brain injury was severe in 34 patients (29.8%), moderate in four patients (4.5%) and mild in 14 patients (1.3%). Our study showed traffic accidents as the main cause of head injuries. Therefore, preventing road accidents could reduce the rate of head injuries.

Background and Major depressive disorder is a common, but serious, psychiatric dysfunction that affects 21% of the population worldwide. A first-line treatment for this disorder is pharmacotherapy that affects some clinical symptoms of the disorder, such as low mood, sleep and appetite disturbances, feelings of hopelessness and deficit in memory. Due to inconsistent findings about the efficacy of antidepressants on memory (explicit and implicit), this study aimed at comparing implicit and explicit memory in patients recovered from depression through medication and normal participants. In an ex post facto study, 20 depressive symptom-free patients were selected using convenience sampling. Also, 20 normal individuals were matched for age and sex who were selected based on clinical interviews. To assess implicit and explicit memory performance, free recall test and complement root word were used, respectively. The results revealed no significant differences between the two groups for explicit and implicit memory scores (P>0.05). The present study showed that people on antidepressants who showed improvements in mood, also had normal implicit and explicit memory performance. These findings demonstrate the effect of drugs on cognitive aspects of depression, which of course should be administered with caution

Background and Disinfection is one of the most important stages in water treatment. So far, various chemical disinfection methods such as chlorination have been widely used. However, these methods have serious disadvantages, like producing DBPs. The purpose of this research was to study the efficacy of nTiO2 photocatalyst process on removing E.Coli as a water microbial pollution index and effects of some parameters on its efficiency. Water was artificially contaminated with E.Coli. Culture method and counting were performed according to standard methods for water and wastewater and was reported as CFU/ml. The size of nTiO2 was 20 nm that was used in the presence or absence of UV for disinfection. The Kolmogorov-Smirnov Test was used to check the normality of the data. The ANOVA and T-Test were used for analyzing the data. The results indicated that the inactivation of Escherichia coli increased with increase of nTiO2 catalyst dose and contact time. However, the efficiency decreased when the number of colonies increased. Minimum, average and maximum percentage removal of nTiO2+UV process were 75.1, 88.9±12.7, and 100%, respectively, in 40 min contact time and 0.8 g/L catalyst dose. The bacteria mortality rate in the presence of UV alone was more than that of the nTiO2 alone process. However, the efficiency of the photocatalytic process (UV+nTiO2) was more than that of the UV alone or nTiO2 alone.

Background and Dual-energy mammography is a technique which is used to enhance the accuracy of breast cancer diagnosis especially in dense breasts. This study was conducted based on the simultaneous use of two contrast agents for automatic separation and also to evaluate their accuracy using dual-energy digital mammography. A breast phantom was designed and built. Different thicknesses of aluminum sheets were imaged for micro-calcification simulation and Iodine and Bismuth contrast agents were placed at various density thicknesses inside the phantom. Also, an X-ray tube with Tungsten anode and a flat panel semiconductor detector Si/GadOx was used for imaging processes. To apply dual-energy imaging, appropriate filter for high-energy spectrum was designed by MCNP-4C Monte Carlo code and built. Matlab software was used for equations solving and image processing. The separation of Iodine images was prepared for thicknesses greater than 0.5 mg/cm2and Bismuth images greater than 0.53 mg/cm2. According to the results, simultaneous isolation of two contrast agent images, I and Bi, from breast tissue were accurately prepared by dual-energy digital mammography via choosing appropriate contrast agent materials and image processing technique. So, this method could help the physicians in making an easy and more accurate diagnosis.

Background and Chemical dyes are widely used in textile industries and have harmful effects on the environment. They also contain carcinogenic and mutagenic substances. The goal of this study was optimization of the catalytic ozonation process using bone char ash modified by magnesium oxide in removal of reactive black 5dye from textile wastewater based on Taguchi design. In this study ozonation was performed in a batch ozonation reactor. In order to remove the dyes, Bone char ash (BCA) was modified by magnesium oxide. The effect of various parameters such as reaction time, initial dye concentration, adsorbent dose, and initial pH at 4 different levels were investigated using an L-16 Taguchi method. Analysis and interpretation of data was done using Minitab V.16. The optimum conditions for removal of dye were found to be contact time of 20 min, pH 8, dye concentration of 50 mg/l, adsorbent dosage of 0.3 g/L. The efficiency of dye removal was 98% and COD removal was 85%. Analysis of variance indicated that the dye concentration was the most important variable influencing the dye removal percentage (51.8%) and pH was the least influencing variable (3.8%) in removal of dye. The results showed that ozonation process was an effective method in reducing the concentration of pollutants in textile wastewater effluent.

Background and The purpose of this study was to assess the Within-day and Between-days reliability of abdominal muscles size measurement in patients with chronic non-specific low back pain (LBP) using ultrasound (US). In this study, 15 patients with chronic non-specific LBP (20-50 years old) were recruited. The reliability of the abdominal muscle size (External and Internal oblique, and Transversus abdominis) was assessed in a relaxed and contraction state by a real time US. Two images were taken on the same day with an hour interval to assess the within day reliability and the third image was taken a week later to determine the between- days reliability. Within-day and between-days reliability of abdominal muscles thickness measurements using US in patients with nonspecific chronic LBP in both rest and contraction state found to be high, ICC = 0.90 for within and ICC=0.85 for between-days of Transversus abdominis muscle in rest state and ICC= 0.82 and 0.86 in contraction state, respectively. For Internal oblique muscle, ICC=0.90 (82%) and ICC=0.88 (88%) were found for within-day and between-days in rest and contraction state, respectively. Within-day and between-days reliability at rest of ICC=0.86 (79%) and in contraction state of ICC=0.79 (75%) were demonstrated for External Oblique muscle. Results of the present study suggest US as a reliable method to evaluate the thickness of the abdominal muscles which could be used as a reliable tool in the assessment of patients and also in evaluating the effect of different therapeutic interventions.

Background and According to the Iranian Health Ministry, the incidence of renal failure is 2.5 per thousand. One of the main treatments of this disease is hemodialysis. The main aim of this study was to estimate the survival rate of hemodialysis patients and also to choose a suitable model for survival in this group of patients. This retrospective cohort study was performed using the medical records of 500 patients during 2007 to 2013. Kaplan-Meier survival estimate was used and evaluation of the model was performed. The median survival time was 108 months for the patients. This rate for one, two, three, five and ten years were 83%, 77%, 71%, 58%, and 42%, respectively. The median survival time was 243.69+69 for patients who did not smoke. The survival time was considerably different in patients with diabetes. Evaluation of the model showed that the gamma distribution fits better than other distributions for the survival of hemodialysis patients.

Background and Rhamnus cornifolia is one of the species belonging to the rhamnaceae family that is abundantly found in different parts of Iran. Rhamnus frangula is one of the most important species of this family which contains anthraquinones that act as stimulant laxative. In this study we investigated Rhamnus cornifolia Boiss which to the best of our knowledge, no phytochemical study has been done on this plant yet. The plants were collected from Sisakht, Iran and morphological and microscopical characters of the plant were examined. An Antrakinon compound was isolated from the bark of the plant by column and thin-layer chromatography and identified by infrared, ultraviolet and mass spectrometry. Quantitative determination of total ash, water-soluble ash, acid-insoluble ash and sulphated ash were performed in the bark of Rhamnus cornifolia. Vitamin C concentrations in leaves were determined by titrimetric method. The structure of the isolated anthraquinone compound was identified to be 1-Hydroxy-3-methyl-6-vinyl-8-glycoside anthraquinone. Total ash, water-soluble ash, acid-insoluble ash and sulphated ash in the bark of Rhamnus cornifolia was 1.67%, 0.4%, 1.56% and 4.35%, respectively. Rhamnus cornifolia is believed to be a species that contains valuable active ingredients.

Background and Acetaminophen that is used as an analgesic and antipyretic drug can induce severe hepatotoxicity in humans following accidental or intentional overdose. Taurine is one of the most abundant amino acids in the body that is not incorporated into proteins but is found as a free amino acid in the body. This study aimed at investigating the changes in plasma concentration of taurine and liver biomarkers in acute poisoning with acetaminophen. We measured the taurine concentrations in plasma in 30 acutely poisoned patients with acetaminophen attending the poison department in Sina Hospital in admission time and 12 hours after admission and in 30 healthy individuals (control group) using high performance liquid chromatography (HPLC). Also, ALT, AST, and PT as biomarkers of liver were measured by Auto-Analyzer. Data was analyzed using two-tailed unpaired student t-test and ANOVA. Mean plasma taurine concentrations in the Acetaminophen -poisoned patients in admission, and 12 hours after admission were 36.91±3.449 mg/l and 27.82±4.020 mg/l, respectively. Significant differences were seen in the mean plasma taurine concentration between the patients and the control group (4.62 ± 0.451) (P<0.001). There was no significant correlation between plasma taurine concentrations and plasma ALT, AST, and PT (P>0.05). Taurine is released by the liver in response to a toxic insult in the first 12 hours and is increased in plasma and urine, whereas, other liver biomarkers are increased in liver 12 hours following acetaminophen overdose.

Background and Low health related quality of life is one of the most important consequences of diseases. Patients’ believes about different aspects of new situation influences the consequences of illness and their quality of life. This study aimed at investigating the relationship between illness perceptions and quality of life after coronary artery bypass graft surgery (CABG). In a cross-sectional survey research, 102 patients were studied after CABG in Alzahra Hospital in Shiraz. Patients were selected according to convenience sampling. Illness Perception Questionnaire (IPQ) and global Quality of Life questionnaire (WHOQOL-BREF) were used to collect the data. Significant association was observed between patient’s illness perception and quality of life. Among illness perception subscales, time line (r= 0.501, P< 0.001), causal representation (r= 0.210, P< 0.05), illness coherence (r= 0.210, P< 0.05), personal control (r= 0.467, P< 0.001), treatment control (r= 0.380, P< 0.001), and emotional representations (r= 0.312, P< 0.001) had the most significant correlation with quality of life. Also, quality of life was significantly associated with sex (P<0.001), level of education (P<0.03) income (P<0.001), and occupation (P< 0.001). Illness perception about coronary artery disease has significant effects on disease outcomes and quality of life of patients after treatment. Therefore, psychological interventions focusing on this factor are recommended in involved patients.

Background and Medical wastes are amongst the main problems of solid waste management and have some serious health risks. Their management is of great importance since they could threaten human health. The aim of this study was to determine the quality, quantity and the method of medical waste disposal in Gachsaran. A cross-sectional study was conducted in healthcare settings in Gachsaran including 20 doctor’s offices, seven clinics, five health stations, four outpatient clinics, three laboratories, nine health centers, and 51 health houses. Census sampling was performed in which three samples were chosen during three months from each healthcare setting. The mean of three samples was considered as the final weight. Excel and SPSS software and descriptive statistics were applied to analyze the data. The mean amounts of total waste, infectious waste, and non-infectious waste generated in Ghachsaran health settings were 625, 201, and 424 kg per day, respectively. Total amount of referrals was 2031 and the amount of waste produced per capita was 307.7g. Doctor’s offices and health houses generated the highest and lowest amount of infectious wastes (70 and 4.5 kg, respectively). Infectious wastes are produced at a high rate in healthcare settings. Moreover, there are different types of healthcare settings that generate many wastes, therefore, it is necessary to perform continues monitoring, on their management, particularly on collection and disposal process. These measures could maintain and enhance the health of exposed people and other people in the society.

Background and Around three million fetuses lose their life before birth each year. Recognizing the risk factors of these deaths could help in controlling and preventing at least a number of them. This study was conducted to determine the risk factors for uterine deaths. This cross-sectional study was conducted in 225 cases of fetus uterine deaths aged >20 week that occurred in Mashhad Ghaem Hospital during 2011-2014. Data was collected using a researcher-made questionnaire in three parts (maternal, fetal and placenta characteristics). We investigated the epidemiologic information, diagnostic and therapeutic measures, and the process of disease before death including fetal, maternal, membrane and placental characteristics. Then influencing factors and causes of deaths were examined in a specialized committee. The main risk factors for fetal death included idiopathic (86 cases, 38.2%), fetal (83, 36.9%), placental and umbilical cord (29, 12%), and maternal (27, 12%). The most prevalent maternal disease during pregnancy was hypertension (21.3%). Unclassified abnormalities (15 cases, 7.4%) and neural tube defects (14, 6.9%) were found more in dead fetuses. Placenta was reported unusual in 84 cases (37.3%). Controlling and appropriate treatment of maternal diseases in pregnancy, early detection and proper treatment of congenital anomalies, placenta and membranes problems could be of great benefit in reducing the rate of fetal death. Also, consulting and training programs for mothers who are more at risk during pregnancy, applying therapeutic interventions and proper management of delivery can be helpful.

Background and Anxiety and thought fusion are common problems in generalized anxiety disorder (GAD). The control of anxiety and worry is difficult and causes serious problems in patients’ lives. A treatment that could reduce these symptoms can reduce psychopathology, and improve their quality of life. This study investigated the efficacy of metacognitive therapy on anxiety and thought fusion in patients with GAD. A semi-experimental study was performed using pretest posttest design and a control group. The research population included married women in Ahvaz suffering from GAD who were selected via convenience sampling. The samples were 30 married women who were willing to participate in the study. They were randomly assigned into experimental (n=15) and control groups (n=15). Beck Anxiety Inventory and Thought Fusion Questionnaire were used. Metacognitive therapy was administered to the experimental group in ten-weekly, 120 minutes sessions during 2/5 months period while the control group received no intervention. All subjects completed Beck Anxiety Inventory and Thought Fusion Questionnaire in pre-test, posttest and follow up. The results of multivariate covariance analysis showed significant effect of metacognitive therapy on anxiety (F=111.61, P=0.001) and thought fusion (F=134.19, P=0.001) in the experimental group. The treatment results remained unchanged in 3 months follow up for anxiety (F=57.67, P=0.001) and thought fusion (F=120.1, P=0.001). Metacognitive therapy is effective on reduction of pathological symptoms in GAD.

Background and Due to creation of scattered radiation when using non-carbon fiber base plates particularly in treating breast cancer, applying this device can affect skin and body surface dose. Recently, using Gaf-Chromic films have led to obtaining good results in skin dosimetry. The purpose of this study was the estimation of skin dose in applying non-carbon fiber base plates using water phantom and Gaf-chromic films. In an experimental study, calibration curves in 6 and 15 MV photon mode of operation of a Siemens Primus were derived for the EB2 Gaf-Chromic films. To obtain these curves parallel plate Roos dosimeter was utilized. To measure the effect of non-carbon fiber base plate, films were attached to the bottom of a 30×30×30 cm3 water phantom and were exposed in two different energies with and without placing the non-carbon fiber base plate on the Linac coach. Calibration curves for both energies were fairly correlated to linear functions. Percentage difference for the mentioned situations (with and without using base plate) for 6 and 15 MV energies were 16.56% and 5.27%, respectively. In breast cancer radiation therapy, applying non-carbon fiber base plate, can increase the skin dose in posterior supraclavicular field. In this study the increase was more pronounced in 6 MV energy than 15 MV.

Background and Today Assisted Reproductive Techniques (ART) are widely applied in Islamic countries according to religious rules. This study aimed at investigating the attitudes of infertile women towards oocyte donation who referred to an infertility clinic in Sari. Oocyte Donation Questionnaire was used to collect the data from infertile women attending Imam Khomeyni IVF Centre in 2012-2013. There was a significant difference between the level of education and positive attitude in accepting oocyte donation. Among the participants 78.4% were willing to receive oocytes from anonymous donors and 22.3% said that they would tell the truth to the baby born via egg donation. There were 73.3% who found this technique contrary to Islamic beliefs. More attention is needed on social and economic issues affecting the attitudes of people towards oocyte donation. Significant correlation between the level of education and positive attitude towards oocyte donation calls for holding more educational classes and conferences and informing the public through mass media. These, could also increase the religious knowledge of people towards the benefits of this technique.

Background and Fibromyalgia syndrome is a chronic bone and skeleton disorder with an unknown aetiology that is characterized by widespread muscle and soft tissue pain. The aim of this research was to analyse the psychological disorders (axis one) in Fibromyalgia patients and frequencies of affective disorders, anxiety disorders and psychoses among them. In a descriptive study 61 patients (aged 16 to 67) suffering from Fibromyalgia were studied who were attending Imam Khomeini Hospital and Tooba clinic in Sari. Demographic questionnaire was applied and a structured SCID interview was conducted for identifying Axis One in DSM-IV-TR. The subjects were 98.4% female and 1.6% men. The frequencies of affective disorders and anxiety disorders were 34.4% and 65.65%, respectively. Among the subjects 30.3% were found with prominent anxiety disorder, 3.03% had dysthymia disorders, and 21.2% had pervasive anxiety. There were 18.8% with acute sensitivity, 16% phobic and 8% who suffered from stress after trauma. Psychotic disorders were not observed in Fibromyalgia patients. High frequencies of affective and anxiety disorders in Fibromyalgia patients calls for more researches in this field. On the other hand, these disorders could be cured, so, physicians should make an accurate diagnose of psychological disorders and provide appropriate treatment.

Background and Melasma is a pigmentation of facial area that is seen mostly in women. Endocrine disorders are involved in development of melasma. This study was designed to evaluate the topical effect of a triple combination therapy in patients with melasma. This clinical trial was conducted in 70 patients with melasma attending a Dermatology Clinic. All patients with melasma received triple combination (hydroquinone 5%, salicylic acid 4%, and fluocinolone 0.01%) and vitamin C 2% for 6 months. The efficacy of treatment was evaluated based on Melasma Area and Severity Index (MASI) Score and patients’ satisfaction was evaluated according to a questionnaire based on Satisfaction Index (SI). Data analysis was performed applying qui square test, binomial test, and repeated measures ANOVA. Among the patients 93% were women and the mean age of participants was 35.21±7.5. Mean MASI Score was 27.07±10.24 at the beginning of the treatment and a significant decrease was seen at the end of first month (7.17±3.64), second (6.97±2.97), third (8.64±3.77), fourth (8.96±4.77), and sixth months (7.77±4.86). Triple combination therapy (hydroquinone 5%, salicylic acid 4%, and fluocinolone 0.01%) was found effective in treatment of melasma and could be used as a new protocol.

Background and This research aimed at studying the efficacy of cognitive-existential group therapy on levels of depression, anxiety, and stress in patients with Multiple Sclerosis (MS). This study was performed using semi-experimental and the extended pretest-posttest design. The study population included all patients with MS who were members of the Mazandaran MS Society, in 2013. The subjects were 20 females selected through accessible sampling, and they were randomly allocated into two groups (intervention and control, n=10 per group). All participants completed the Depression, Anxiety and Stress (DAS) measurement test in both pre-test and post-test stages. For the intervention group cognitive-existential group therapy was performed in 8 sessions, but the control group did not receive any intervention. Descriptive statistics and covariance analysis were applied to analyze the data. The covariance analysis showed that the cognitive-existential group therapy led to a significant decrease in levels of depression (P <0.0001) and stress (P <0.0001) in the intervention group. Also, the cognitive-existential group therapy had a positive effect in lowering the anxiety level in this group, but this effect was not significant. According to this research, the cognitive-existential approach is an effective way that could be of great benefit in solving the emotional problems of patients with MS.

Background and Mitral valve prolapse is a common finding in different age groups that is often without any sign but sometimes accompanied by chest pain, panic and anxiety attacks. Although these symptoms are less prevalent in children, but their identification, to some extent, can help in preventing them. The aim of this study was to determine the prevalence of mitral valve prolapse in children attending Pediatrics Heart Clinic in Imam Hussein Hospital, 2014. Children (aged 3-16 years of old) who referred with chest pain were examined in Pediatrics Heart Clinic, 2014.Then, electrocardiography (ECG) and chest x-ray were ordered and echocardiography was also performed. At first mitral valve was assessed and in case of mitral valve prolapse more than 1 millimeters, diagnosis was made in Four chamber and Long Axis and then confirmed. A total of 94 children with chest pain were examined, among whom 49 (52.1%) were girl and 45 (47.9%) were boy. The majority of the children were diagnosed with mitral valve prolapse (92 cases, 97.9%). They all had chest pain and 36 (38.3%) had dysrhythmia. Shortness of breath was observed in 4 (4.3%) and history of faint was also reported in 4 (4.3%). ECG was abnormal in 5 children (5.3%). Sudden death was not observed in any one. The prevalence of mitral valve prolapse in studied Iranian children was high and most of them were asymptomatic.

Background and Metabolic syndrome or X syndrome is a term that refer to a set of metabolic abnormalities including insulin resistance, hypertension, dyslipidemia and central or visceral obesity. There is a high prevalence and increased risk of atherosclerotic disease and mortality. This study was designed to investigate the prevalence of metabolic syndrome in Health Network personnel in Babolsar. A cross-sectional study was conducted consisting of all the staff (n= 134) in Babolsar Health Network, 2012. Data was analyzed applying qui square test in SPSS. The prevalence of metabolic syndrome was investigated using ATP III and IDF criteria. The prevalence of metabolic syndrome was 9% (12 people) and their mean age was 39.8 + 7.28. This prevalence was found to be more in men. Metabolic syndrome could have many complications including cardiovascular diseases and type 2 diabetes. Therefore, screening programs are required in Iran in people aged >30 years. High incidence of metabolic syndrome in male staff calls for more attention on appropriate management and providing effective training to reduce the rate of mortality and morbidity due to cardiovascular diseases and type II diabetes in this group.

Background and Fish Consumption Guidelines have been established by some countries to guard the public from the potentially harmful health effects related to eating contaminated fish. Guidelines are according to estimations of the health risks linked to concentrations of contaminating chemicals found in fish, and the mean levels of consumption of fish in general population. Fish is an important source of nutrition in coast of the Caspian Sea; but, little is known about the health risks associated with concentrations of metals in fish. The aims of this research was to estimate the daily intake and risk assessment of heavy metals via consumption of Liza salines captured from Gomishan wetland and to provide reliable guidelines on fish consumption. The samples of fish (Liza salines) were randomly collected from different stations in Gomishan wetland. The heavy metals were extracted from the fish muscle by the wet digestion procedure (Nitric acid and Perchloric acid). The concentrations of heavy metals were determined using the GFAAS. Daily intake and potential risk were estimated according to the guideline of the US-EPA. The accumulated heavy metals in muscle of Liza salines were found to be lower than international standard levels. The highest and lowest daily intake values were observed in Cd and Pb, respectively. The estimated daily and weekly intake values for metals were found lower than the guidelines proposed by Environmental Protection Agency. This study showed that Target Hazard Quotients and Hazard Index values are less than 1. The results of all estimations (Estimated Daily Intake, Estimated Weekly Intake, Target Hazard Quotients and Hazard Index) indicates that no health risks would arise from the long-term consumption of these fish species.

Background and Colorectal cancer is the most common gastrointestinal cancer throughout the world. Knowledge about the disease incidence and its changes over time can be useful in planning for the prevention and cause detection, therefore this study aimed at investigating the incidence of gastric cancer in Iran. This study was a reanalysis of existing data. We used the information published by National Cancer Registry System in Iran that were recorded between 2003- 2009. The incidence rates were then standardized using direct method by the World Health Organization standard population, and the incidence of this disease was determined. The total number of colorectal cancers was 31,974 cases. Most cases were observed in 2009 and lowest rate was seen in 2003. The highest and lowest incident rates for men were found in Tehran province (2008) and South Khorasan Province (2007), respectively. For women the highest incidence of disease was recorded in Gilan province in 2008 and lowest reported in South Khorasan Province in 2008. This study showed increasing trend in incidence of colorectal cancer in Iran. The rate of the disease is also increasing throughout the world but this could be prevented with educational interventions, screening for early diagnosis, thereby treatment in younger patients.

Background and Considering the important and effective role of universities in science product and promotion of scientific status throughout the country and the world, the present research intends to investigate Mazandaran University of Medical Sciences researchers and members of academic board scientific outputs at Scopus database during the years 1992-2013 and draw this university’s scientific map. The present research is a Survey descriptive research done in Scientometrics approach. Study population consists of indexed scientific documents and articles at Scopus Database of which at least name of one writer with Organizational affiliation to Mazandaran University of Medical Sciences has been observed. Findings have shown a positive growth in scientific products of Mazandaran University of Medical Sciences researchers during the years studied and has increased from 2 cases in 1997 to 345 cases in 2013 and totally 1540 scientific documents have been registered by researchers with organizational affiliation to Mazandaran University of Medical Sciences. Despite the positive growth of Mazandaran University of Medical Sciences researchers’ scientific products quantitatively, a significant part of articles have been printed in journals with low impact factor. Besides, produce of the works of academic board members and researchers and university students in English language is inevitable and necessary in order to disseminate science and technology findings, promote and achieve a higher rank in scientific database and universities rankings

Controlling the release of drugs and other therapeutic molecules has great importance in novel drug delivery. Nanoparticulate systems have the ability to control drug release and increase the presence of these compounds in blood flow and could convey them to a specific position. Growth factors are endogenous peptide which begins cellular signals to regulate cellular activities. The main problem is the instability of these factors in bloodstream and lack of proper distribution in systemic administration. Nanoparticles mainly nanocarriers have the ability to overcome this problem and play a great role in intelligentization of tissue engineering because of their unique features, including the creation of physical protection and collaboration with the scaffolds and cells. Due to the increasing use of growth factors in healing damaged tissues, and their application in tissue engineering, in this article a number of nanoparticles useful for the release of growth factors with a few examples are reviewed.

The genus Entamoeba contains many species, six of which (Entamoeba histolytica, Entamoeba dispar, Entamoeba moshkovskii, Entamoeba polecki, Entamoeba coli, and Entamoeba hartmanni) reside in the human intestinal lumen. Entamoeba histolytica is the causative agent of amebiasis in humans with a worldwide distribution. Correct detection of E.histolytica is frequently a major concern in diagnostic medical laboratories that also influences treatment procedure. Data was collected through available scientific databases such as Google scholar, Pub Med, IranMedex, ScienceDirect, SID and parasitology text books. Among diagnostic methods, microscopic and serological methods despite their wide application are not efficient. New approaches to the identification of E. histolytica are based on detection of E. histolytica-specific antigen and DNA in stool and other clinical samples. Several molecular diagnostic tests have been developed for the detection and differentiation of E. histolytica, E. dispar, and E. moshkovskii (which share identical morphology) in clinical samples. Application of specific diagnostic methods was recommended to avoid misdiagnosis in individuals infected with other species of Entamoeba such as E. dispar and E. moshkovskii using microscopic examination. Therefore, the integration of new and current accurate diagnostic methods will lead to a better understanding of the amebiasis. The aim of this non-systematic review was to investigate different diagnostic and differential detection methods for E. histolytica, E. dispar, and E. moshkovskii.

Multiple Sclerosis (MS) is a complex autoimmune demyelinating disease of the central nervous system. Although the main cause of MS is still unknown, several risk factors may contribute in MS development. In the search for the etiology of MS, infectious agents, genetic factors, and/or their combination were believed to participate in MS occurrence. The association between MS and infectious diseases was proposed by Pierre Marie in 1884. It was later accepted following epidemiological studies, analysis on twins, immigrants and animal model. This study aimed at investigating the possible relationship between infectious agents and MS. Our findings showed that viral agents such as EBV, borna virus, measles, mumps, and fungi are possible agents in MS development, while parasites may induce immunomodulatory effects. Identifying the relationship between MS and infectious agents and determining a special pathogenic agent for MS could lead to novel treatment strategies. Furthermore, it may result in developing preventive programs. Therefore, further studies are needed to understand and identify the infectious agents that might affect the pathogenesis of MS and their mechanism of actions.