Journal of Mazandaran University of Medical Sciences
Year:2021 | Volume:31 | Issue:196|Papers Count:20

Background and purpose: Type 2 diabetes is the most common endocrine disease due to glucose intolerance and imbalance between reserves and insulin demand. The aim of this study was to investigate the interactive effect of intensity interval training and n-chromosomal royal jelly on PEPCK gene expression of hepatocytes and glucose levels and insulin resistance in type 2 diabetic rats. Materials and methods: This experimental study was done in 36 Wistar rats (4-6 weeks, 100± 20 g). After 20 weeks of high-fat diet, diabetes was induced by intraperitoneal injection of 25 mg STZ per kg body weight. The rats were treated in four groups: control (n=8), training (n=10), royal jelly (n=8), and training-Royal Jelly (n=10). Training protocol continued for eight weeks, including Highintensity interval training (HIIT) for five sessions per week with 2-minute alternation of 2 and 8 interval at 80 to 90% vo2max and a one-minute rest cycle at 50 to 56% vo2max. Results: Compared to the control group, aerobic exercise led to significant reductions in glucose level and insulin resistance (both P<0. 001). Exercise and royal jelly also resulted in increased PEPCK expression in hepatocytes compared to the controls. Conclusion: Improvement of glycemic profile in response to HIIT and royal jelly in diabetic rats can be attributed to changes in glucose and insulin levels and as well as changes in the expression of PEPCK hepatic gluconeogenic gene.

Background and purpose: Hospitals are one of the vital pillars of the health system. Hospital preparedness in epidemics is a dynamic, complex and multidimensional process that shows the developed capacities and capabilities of the hospital in predicting, reducing the effects, resistance, response, and recovery in the face of biological events. The aim of this study was to investigate the readiness of hospitals in response to the pandemic of COVID-19 disease in Mazandaran province, Iran. Materials and methods: This cross-sectional study was performed in April 2020 using the standard checklist of the Pan American World Health Organization (PAHO 2019). The checklist consists of ten components: incident management system (7 items), coordination (2 items), information management (2 items), logistics (7 items), finance and administration (1item), detection (3 items), diagnosis (3 items), isolation (3 items), cases management (4 items), and prevention and infection control (10 items). Data were analyzed applying Kruskal-Wallis test in SPSS V18. Results: We studied 39 hospitals in the province, including university hospitals (n=26), social security hospitals (n=4), and private hospitals (n=9). Social security hospitals showed the highest level of readiness (mean score= 82 out of 84), university hospitals had moderate level of readiness (mean score= 72. 72 out of 84), and private hospitals had the lowest mean score for readiness (72. 5 out of 84). According to the total scores, operational readiness was at a good level. Conclusion: The readiness of the hospitals in the face of the COVID-19 pandemic was at a good level in Mazandaran province. However, due to the prolonged pandemic and uncertainty about when it comes to an end, monitoring the key components is essential to maintain high level of preparation.

Background and purpose: There are few treatment options available for treatment of toxoplasmosis and effective drugs have serious toxic effects. In this study, the in vivo and in vitro anti-toxoplasma activities of Heracleum persicum and Foeniculum vulgare fruits essential oils were investigated. Materials and methods: In vitro, Vero cells were incubated with different concentrations of essential oils or pyrimethamine (positive control) and the cellular viability was determined. Next, Vero cells were infected with T. gondii (RH strain) and treated with agents. Then, the CC50, IC50, and selectivity index (SI) were calculated. Moreover, in vivo, the effect of oils on survival times of Balb/c mice infected with T. gondii were determined. Results: In vitro results showed that the oils exhibited less cell toxicity than pyrimethamine. The selective index was 2. 94, 6. 96, and 3. 06 for Heracleum persicum, Foeniculum vulgare, and pyrimethamine, respectively. Also, the infected mice treated with F. vulgare-pyrimethamine showed a better survival rate than others (P<0. 05). Conclusion: The H. persicum and F. vulgare essential oils showed anti-toxoplasmic activity in vitro and in vivo, but, combination therapy with F. vulgare and pyrimethamine showed a better survival time in mice infected with T. gondii. Therefore, F. vulgare may be a useful candidate in treatment of Toxoplasmosis. However, further studies are needed to investigate the fractions of this plant against T. gondii.

Background and purpose: The present study aimed at exploring the effects of eight-week high intensity interval training (HIIT) program on gene expression factors involved in cholesterol reverse transport in liver tissue of ischemic rats. Materials and methods: In this study, 28 Wistar Rats (250 ± 20 g) were randomly divided into four groups: Ischemia (n=8), Placebo (n=8), Training (n=8), and Ischemia plus Training (n=8). Myocardial infarction was induced by ligation of left anterior descending coronary artery (LAD) for 30 minutes. High intensity interval training program (4 min of running at 85-90% VO2max and 2 min active recovery at 50-60% VO2max) was performed using treadmill for 8 weeks (three times a week /40 minutes). Results: The expression levels of ABCG1 receptor gene and Apolipoprotein A1 significantly increased in high intensity interval training group compared to Ischemia group (P=0. 008) and placebo group (P= 0. 037). Also, the expression of Apolipoprotein 2 receptor gene showed significant increase in HIIT+ Ischemia group compared to Ischemia group (P=0. 041) and placebo group (P=0. 04). In addition, the expression of SR-BR receptor gene was found to increase in HIIT+ Ischemia group compared to the placebo group (P=0. 028). Conclusion: High intensity interval training in ischemic rats increases the key factors involved in reverse cholesterol transfer process and ultimately leads to an increase in HDL, which has a positive effect on prevention of atherosclerosis and ischemia.

Background and purpose: Dental plaque is a biofilm that is formed on the surface of the tooth. Carious lesions are caused by inappropriate ecological changes in microbial flora of the plaque biofilm. In this study, the effect of Lactobacillus casei bacteriocin, isolated from dairy products, was investigated on Streptococcus salivarius biofilm formation. Materials and methods: In this experimental study, MRS Broth and MRS Agar medium were used to isolate three strains of Lactobacillus casei probiotic from milk samples under microaerophilic conditions. The initial identification of Lactobacillus casei was performed by sugar fermentation and other biochemical tests. Then, 16SrRNA encoding gene was confirmed by PCR and sequenced. At last, Bacteriocin was isolated by ammonium sulfate sedimentation and its molecular weight was measured by SDS-PAGE and the antimicrobial activities were investigated. The Streptococcus salivarius were isolated from dental plaque and phenotypically and biotypically identified. Molecular confirmation of the isolates was performed using gtfK specific gene by PCR. The ability to form Streptococcus salivarius biofilm and the effect of bacteriocin on biofilm formation were measured by microtiter plate. Results: After partial purification of Lactobacillus casei probiotic from dairy products, two LC3 and LC1 protein samples formed bands (35-40 kDa and about 75 kDa, respectively). The supernatant fluid from the cultivation of Lactobacillus casei and bacteriocins showed antibacterial effects against Streptococcus salivarius isolates from dental plaque and the formation of biofilm by this bacterium. Conclusion: According to this study, bacteriocin and supernatant fluid from Lactobacillus casei cultures could inhibit the growth of Streptococcus salivarius and also reduced biofilm formation, so, it could be used in oral care products.

Background and purpose: Bone fusion is a dynamic process and availability of calcium and balance of vitamin D can be effective in post spinal cord fusion. There are contradictory results on this issue, so, we decided to compare the effect of administration of vitamin D and alendronate on lumbosacral vertebral fusion in patients undergoing posterior spinal fusion surgery. Materials and methods: A single-blind clinical trial was carried out in 75 patients. Patients were divided into three groups (n=25 per group) using block randomization: Alendronate group who received 70 mg oral alendronate every two weeks, Vitamin D group to receive vitamin D 50, 000 units per month for six months, and control group who received routine treatment after the surgery. After six months, the patients underwent CT scan of the lumbar region for clinical assessment of lumbar fusion. Pain intensity was assessed using Visual Analogue Scale (VAS), one and six months after the surgery. Data analysis was performed in SPSS V16. Results: Before surgery, pain intensity was higher in vitamin D group (6. 36 ± 1. 3) than the controls and alendronate group (P <0. 0001). The last VAS in this group reached 2. 12 ± 0. 97 indicating decrease in pain intensity. Overall, there was a significant decrease in pain intensity in all three groups (P<0. 0001). Non-fusion was found to be more frequent in control group (16%) compared to the vitamin D (12%) and alendronate (8%) groups (P=0. 900). Conclusion: In current study, vitamin D and alendronate supplementation slightly improved lumbosacral fusion. Therefore, further studies are needed to investigate the effectiveness of combined treatment with alendronate and vitamin D on pain intensity and lumbosacral fusion in these patients.

Background and purpose: Coronavirus Disease-2019 )COVID-19) is a respiratory infection which was recognized as a pandemic by the world health organization on march 11, 2020. This study aimed to evaluate new treatment modalities therapy in management of COVID-19. Materials and methods: A descriptive-analytical, retrospective study was performed in patients over 17 years of age with suspected COVID-19 admitted to Qaemshahar Razi Hospital in March and April 2020. The case group included patients treated with methylprednisolone, intravenous immunoglobulin (IVIg), Beta Interferon, Ribavirin, Arbidol, Remdesivir, Favipiravir and Hydroxychloroquine and lopinavir/ritonavir. The control group was selected from hospitalized cases who were treated only with lopinavir/ritonavir and Hydroxychloroquine. This study evaluated the efficacy of these drugs. Data was analyzed in SPSS V18. Results: The mean ages of case group (n=217) and control group were 54. 23± 16. 64 (17-88) years and 53. 8± 16. 23 (19-80) years, respectively. The need for ICU admission and mechanical ventilation were significantly different between the two groups (P<0. 05) but no significant difference was seen on mortality rate (P>0. 05). Conclusion: Using anti-inflammatory and anti-viral drugs in hospitalized patients seems reasonable until widespread vaccination and development of effective drug.

Background and purpose: Colorectal resection is used for various diseases and leakage in an anastomosis is one of its complications. Some studies confirmed the predictive effects of C-reactive protein (CRP) and procalcitonin markers leakage in anastomosis. This study aimed to investigate the prognostic value of CRP and procalcitonin in predicting anastomotic leakage in elective colorectal surgery in Mazandaran province, Iran. Materials and methods: This longitudinal study was performed in patients (n=72) undergoing intestinal anastomosis in Sari Imam Khomeini Hospital, Oct 2016-March 2017. White blood cells (WBC), temperature (T), CRP, and procalcitonin levels were measured at days 3 and 5 after the surgery. Data were analyzed using SPSS V21. Results: Anastomotic leakage occurred in two patients (2. 8%). Procalcitonin levels (P= 0. 000), CRP levels at days 3 (P= 0. 000) and 5 (P= 0. 000), WBC at day 5 (P = 0. 041), and body temperature at days 3 (P= 0. 014) and 5 (P= 0. 004) after the surgery were associated with the incidence of anastomotic leakage. Conclusion: Procalcitonin and CRP levels, WBC count, and body temperature were found to be correlated with anastomotic leakage, so they should be monitored at days 3 and 5 after the surgery to predict the incidence of complications.

Background and purpose: The elongation of styloid process can result in Eagle syndrome. The purpose of this study was to investigate the prevalence and pattern of ossification of elongated styloid process (ESP) in digital panoramic radiography and their association with gender and age. Materials and methods: In this retrospective study, 400 digital panoramic radiographs of patients attending Oral and Maxillofacial Radiology Department in Mazandaran University of Medical Sciences were examined. The length of the styloid process was measured and classified into elongated, pseudoarticular, and segmental types. Length equal to or greater than 30 mm was considered as an elongated styloid process. Data were analyzed in SPSS using Chi-square, t-test, and correlation test. Results: Radiographs of 400 patients including 167 (42%) males and 233 (58%) females aged 11-79 (38. 13 ± 48. 43) years were investigated. ESP was observed in 118 (29. 5%) patients. The prevalence of ESP was significantly higher in males (50. 8%) than females (49. 1%) (P=0. 016). Also, the prevalence of ESP was significantly higher in older adults (P<0. 001). Among the types of ESP, type I was found to be more prevalent. Conclusion: Elongated styloid process was relatively common in the population studied and was significantly correlated with age and sex (more prevalent in males).

Background and purpose: A drug brochure or Patient Package Insert (PPI) is a folded sheet of paper in drug package that provides necessary information for effective and safe use of the drug. PPIs are one of the main sources of drug information, so, they should be clear and easily comprehensible to the general public. The purpose of this study was to determine the awareness and satisfaction of patients with Iranian PPIs. Materials and methods: In this cross-sectional study, 200 patients attending pharmacies of the Tabriz University of Medical Sciences were selected using simple random sampling in 2018-2019. A questionnaire was designed as a five-point Likert scale to determine the patients’ awareness and satisfaction with the Iranian PPIs. Content validity of the questionnaire was confirmed and internal consistency was confirmed by Cronbach’ s alpha coefficient in SPSS (V. 17). The Cronbach’ s alpha was 0. 81. Results: According to findings, the average awareness of patients about Iranian PPIs was 50%. The highest satisfaction with PPIs was for “ pregnancy and lactation warnings” and “ warnings for children” . The overall satisfaction of patients with PPIs was found to be moderate (57%). Conclusion: The current study reported a moderate level of patients’ satisfaction with the Iranian PPIs in Tabriz, Iran. Therefore, appropriate mechanisms should be adopted in the regulations relating to preparation of PPIs and more supervision on pharmaceutical companies by Iran Food and Drug Administration.

Background and purpose: Metadiscourse markers (MDMs) play a significant role in academic witting. They act as a bridge between writers and readers and make a text more understandable. Therefore, this study aimed at investigating the use of MDMs in introduction, methods, results, and discussion (IMRaD) sections of English medical research articles (RAs) published in Iranian and American ISI journals. Materials and methods: In this cross-sectional study, performed in 2020, we selected 60 RAs published in Iranian medical journals and 60 RAs in American medical counterparts. Following Hyland’ s taxonomy, MDMs were identified. Data analysis was done in SPSS V21 applying t-test. Results: The mean scores for MDMs were 5. 40 and 5. 78 in RAs published in Iranian and American journals, respectively that indicated no significant difference between MDMs used by Iranian and non-Iranian authors of medical RAs (P=0. 377). Conclusion: Further trainings on the use of MDMs not only help authors to write more coherently and their intended meanings clear to their audience, but also enables readers to easily interpret the text. In fact, these markers improve the quality of writing and increase the comprehensibility of the text.

Background and purpose: Antibiotic resistance of Klebsiella pneumoniae to quinolones is a serious concern in treatment of nosocomial infections. There are limited reports on the prevalence of plasmid-mediated quinolone resistance genes in K. pneumoniae clinical isolates from Iran. The aim of this study was to investigate the rate of resistance to fluoroquinolone antibiotics, and also the frequency of qnrA, qnrB, and qnrS genes among K. pneumoniae isolates collected from hospitalized patients in Sari, Iran. Materials and methods: In this descriptive cross-sectional study, bacterial isolates were identified by conventional methods and biochemical tests. Resistance to fluoroquinolone antibiotics was evaluated by disk diffusion method. After resistance assessment, amplification of qnrA, qnrB, and qnrS genes in isolates was performed by polymerase chain reaction (PCR). Results: We analyzed 90 isolates and the antibiotic resistance of fluoroquinolone included: nalidixic acid (55%), ciprofloxacin (36%), ofloxacin (31%), levofloxacin (29%), and norfloxacin (22%). The PCR showed that 47 (52%), 22 (25%), and 21(23%) isolates harbored qnrB, qnrA, and qnrS genes, respectively. Conclusion: The outbreak of plasmid-mediated quinolone resistance (PMQR) leads to expand and increases bacterial resistance to fluoroquinolones. Therefore, continuous monitoring of antibiotic sensitivity patterns of K. pneumoniae strains to these agents is necessary.

Background and purpose: At the beginning of 2020, Covid-19 disease spread rapidly in most parts of the world. Meanwhile, medical staff experienced a lot of stress due to the high disease transmission rate and considerable rate of morbidity and mortality. The aim of this study was to explain the psychological experience and psychological needs of nurses working at frontline of treatment of patients with Covid-19. Materials and methods: We performed a phenomenological qualitative research in Sari, Iran May and June 2020. The participants included 9 nurses selected via convenience sampling. Data were collected using in-depth and semi-structured interviews by a psychiatrist. Finally, Data were coded and analyzed using MAXQDA-2020 software. Results: According to findings, three main themes were extracted, each theme was formed from categories and each category included some codes. Emotional experiences, expectations from superiors, and the need for psychological interventions were the main themes. Conclusion: In this study, nurses reported different emotions such as satisfaction, anger, and worries about being at risk of infection and transmitting the disease to their family. The needs of nurses included psychological and financial supports and appreciation and empathy from the authorities, workplace security, and in-person psychological interventions.

Background and purpose: Controlling the toxic effects of lead in biological systems is highly important. This study investigated the effect of sumac (Rhus coriaria L. ) aqueous extract on liver enzymes in lead poisoning and behavioral changes in rats. Materials and methods: This interventional study was performed in 7 groups of rats: control, drinking lead acetate at 500, 1000 and 1500 ppm, sumac aqueous extract 250 mg/kg and lead acetate in drinking water for 29 days. On the last day, after weighing, elevated plus-maze (EPM) test was performed. The serum was separated to measure Total Antioxidant Capacity (TAC), Alkaline Phosphatase (ALP), Alanine Aminotransferase (ALT), and Aspartate transaminase (AST). Malondialdehyde (MDA) concentrations in liver and brain tissues were also determined. Results: The highest average weight at the end, was seen in the group that received 1500 ppm lead acetate. The highest concentrations of liver and brain MDA were observed also in this group (18. 0 ± 6. 766 and 15. 43 ± 0. 432μ mol /ml, respectively) which was higher compared to the control group, 500ppm lead group, and the extract group (P<0. 01). The greatest and lowest TAC were found in the control group (333. 00 ± 22. 204 μ mol/ml) and the 1500 ppm lead group (96. 96 ± 6. 669 μ mol/ml), respectively (P<0. 01). The ALT and AST concentrations were low in the control group and high in the 1500 ppm lead group. The minimum time passed in the open arm in the 1500 ppm lead group was 14. 42%± 8. 247 which was lower compared to the control group (P <0. 01). Conclusion: In current study, sumac aqueous extract reduced the concentrations of liver enzymes in lead poisoning conditions. However, it had no significant effect on controlling lead induced anxiety.

Background and purpose: Psoriasis is a chronic inflammatory genodermatosis, and periodontitis is an inflammatory disease of the protective tissue of the tooth. There is increasing prevalence of psoriasis and periodontitis and some studies indicated a relationship between psoriasis and periodontitis. The purpose of this investigation was to study the frequency and severity of periodontitis in patients with psoriasis. Materials and methods: In this study, the severity of psoriasis and mouth and teeth examination results of 40 patients were recorded. Tooth looseness, number of missing teeth, bleeding on probing, and clinical attachment loss were measured using periodontal probe. Data analysis was carried out applying t test, Chi square, and correlation coefficient. Results: The overall prevalence of periodontal diseases was 80%, including loose teeth (10%), missing teeth (47. 5%), gingival bleeding (60%), and gingival resorption (62. 5%). Periodontal diseases were found to be significantly associated with duration and severity of psoriasis (P = 0. 032 and P <0. 001, respectively). Also, there was a significant association between severity of periodontal diseases and duration and severity of psoriasis (P = 0. 048 and P = 0. 023, respectively). Conclusion: According to this study, periodontal diseases are highly prevalent in patients with psoriasis which are associated with severity and duration of psoriasis. Inflammatory process is involved in both diseases, so, accurate oral examinations for periodontal diseases are strongly suggested in patients with psoriasis.

Background and purpose: Seroma formation is one of the most common complications of hernioplasty surgery. Identifying the factors associated with seroma is useful to prevent this complication. The present study aimed at investigating the frequency of seroma and related demographic and clinical factors after inguinal hernioplasty. Materials and methods: This cross-sectional study was performed in 130 patients with primary inguinal hernia who underwent inguinal hernioplasty using mesh in Rasht Poursina Hospital, 2019. Any accumulation of fluid at/around the surgical site that caused obvious bulging and discomfort, pain, and heaviness that required needle aspiration was considered to be seroma. The frequency of seroma was assessed at 24 hours, one week, and one month after the surgery. Demographic and clinical variables were assessed by oral questioning and reviewing the medical files. Statistical analysis was performed in SPSS V20. Results: Seroma was seen in 5 (3. 8%) (95% CI: 1%-7%), 8 (6. 2%) (95% CI: 2%-10%), and 7 patients (5. 4%) (95% CI: 1. 3%-8. 7%) at 24 hours, one week, and one month after the surgery, respectively. Conclusion: Similar descriptive studies including larger sample size and experimental studies are needed to accurately investigate the relationship between demographic and clinical factors and the incidence of seroma after hernioplasty surgery. Also, assessing the effectiveness of various surgical techniques is of great help in preventing this complication.

Background and purpose: Tympanostomy surgery and ventilation tube (VT) placement are reliable methods to reduce the complications of eustachian tube dysfunction and inadequate middle ear ventilation. However, tympanostomy is associated with some complications. This study aimed to investigate the frequency distribution of tympanostomy surgery, success rate, its complications and the demographic characteristics of patients during 2011-2017 in Sari, Iran. Materials and methods: This retrospective descriptive study was performed using data from the records of 512 patients who underwent VT surgery in Sari during 2011-2017. A checklist was used to collect the data and SPSS V24 was used for data analysis. Results: The most common complaint at the time of referral was hearing loss (38. 3%). In 79%, bilateral VT was performed and 6. 5% had complications after the operation. The most common complication was purulent otorrhea (4. 1%). Postoperative success rate of VT was found to be 93%. Conclusion: Given the high success rate of VT surgery, this procedure could be a good method in treatment of hearing loss, acute recurrent middle ear infections, and the adverse effects of tonsillitis and allergy on middle ear.

Background and purpose: Hepatitis B is one of the most common viral infectious diseases of the liver, which is of particular importance due to the possibility of chronic conditions and high risk of transmission, especially during dental treatments. The best way to combat is preventing the infection. The present study was conducted to determine the level of awareness of general dentists and dental specialists in Sari about hepatitis B. Materials and methods: In a descriptive-analytical study, 142 general dentists and dental specialists were included using census sampling in Sari, Iran 2018. The participants completed a questionnaire designed by Alavian et al. 2011. SPSS V24 was used for data analysis. Results: The subjects were 88 (62. 9%) males and 54 (38. 1%) females. Findings showed that 50% of dentists had a good level of awareness, 44. 37% had a moderate level of awareness and 5. 63% had a low level of awareness about hepatitis B. Overall, the level of awareness was found to have no significant association with gender (P= 0. 58), being a general dentist or dental specialist (P=0. 66), participating in infection control courses (P= 0. 50), and age (P=0. 06(. Conclusion: In this study, dentists were found to have an appropriate level of awareness about hepatitis B, but, there is still a need for retraining courses.

Veterinary pharmaceuticals have a significant role in animal and human health, therefore, production monitoring and quality control of these pharmaceuticals are of special importance. This work presents an overview on veterinary drug residues in food products and the environment and also discusses the main topics of the guidelines of veterinary pharmaceuticals production, quality control, and usage. This review is composed of more than 100 references and reports the findings of 44 studies conducted on drugs residuals of veterinary food products produced in Iran.

Background and purpose: One of the main goals in pediatric dentistry is to maintain deciduous teeth until the permanent teeth grow. In cases where the pulp of deciduous teeth is involved, pulpectomy is needed which requires determining the correct working length of the canals and cleaning and filling their interior space using a proper filling material. The principles of successful endodontic treatment in permanent teeth are well known, but, determining the anatomy of the canal of deciduous teeth is difficult due to the resorption and deposition of hard tissue in the root canal, the shape, dimensions, and variable conditions of root apex. Therefore, in this narrative review, we investigated the accuracy of Ipex-I and Root ZX mini electronic apex locators and conventional radiography in root canal length determination in resorbed primary molars. A thorough search was conducted in Science Direct, Google Scholar, PubMed, Scopus, Irandoc, SID, Magiran, and Iranmedex covering the articles published in 2000– 2020. According to findings, all techniques mentioned were found to have almost similar accuracy in determining the working length in resorbed deciduous molars. However, obtaining radiography images may be difficult in children, therefore, apex locators are more preferable to the conventional method.