Journal of Mazandaran University of Medical Sciences
Year:2022 | Volume:32 | Issue:209|Papers Count:20

Background and purpose: Reduction of muscle mass occurs in some models of muscle atrophy during mechanical unloading status and MST1 and MAFbx genes are believed to have a role. In the present study, the effect of reduced physical activity in the form of spinal nerve ligation (SNL) after a period of endurance training (ET) on the expression of MST1 and MAFbx genes were examined in the rat plantaris muscle. Materials and methods: In this experimental study, 16 rats were randomly divided into two groups: control-spinal nerve ligation (Sham+SNL) and endurance training-spinal nerve ligation (ET+SNL). Training program continued for six weeks, four sessions a week with moderate intensity (7060% of VO2max). To create the SNL model, the rats were first anesthetized with pentobarbitol sodium and then their fifth lumbar spinal nerve was tightly tied. The duration of the SNL protocol was four weeks. After the last day of ligation, the plantaris muscle was extracted. Real-Time PCR was used to measure the mRNA expression of the MST1 and MAFbx. Results: The expression of MST1 gene showed no significant increase in ET+SNL group compared with Sham+SNL group (P>0. 05). But, significant increase was seen in MAFbx gene expression in ET+SNL group compared with Sham+SNL group (P<0. 05). Conclusion: The study showed that reduced activity in the form of SNL after endurance training can lead to destructive effects on the muscular system and symptoms of muscle atrophy could be seen.

Background and purpose: Exposure to organophosphorus (OP) compounds may contribute to an increased risk of cognitive impairments and induction of oxidative stress. The present study was designed to evaluate the effects of exposure to paraoxon (the active metabolite of insecticide parathion) on cognitive function and oxidative stress biomarkers. Materials and methods: Adult male Wistar rats (n= 56, 7 per group) were used in this study. Corn oil or paraoxon at 0. 3, 0. 7, or 1 mg/kg were intraperitoneally administrated. After 14 or 28 days, the animals were examined by Morris water maze to determine spatial learning and memory. The effects of paraoxon on hippocampal glutathione (GSH) and malondialdehyde (MDA) levels were also investigated. Results: Escape latency and swimming distance significantly increased in animals that received 1 mg/kg of paraoxon at both time points (P<0. 001 and P<0. 05, respectively). In the probe test, animals intoxicated with paraoxon 1 mg/kg spent less time in the target zone and had lower swimming distance and swimming speed compared with the control group. No significant difference was observed in the performance of paraoxon-intoxicated animals in the water maze with visible platform compared with the control group (P>0. 05). Exposure to paraoxon 1 mg/kg was associated with decreased GSH and increased MDA levels in the hippocampus. Conclusion: The study showed that exposure to high dose of paraoxon (1 mg/kg) impaired spatial learning and memory independent of any changes in sensorimotor deficit. Induction of oxidative stress plays an important role in development of cognitive impairments caused by exposure to paraoxon.

Background and purpose: Dental caries is one of the most common bacterial diseases in childhood. Using proper dentifrice is suggested to reduce the incidence of this disease. The aim of this study was to investigate the antimicrobial effects of different brands of children's dentifrice available in Iran’, s market on Streptococcus mutans (PTCC1683) and Lactobacillus acidophilus (PTCC4356) strains. Materials and methods: After culturing standard bacterial strains, different kids dentifrice brands, including Irox, Bath, Misswake, Colgate, Oral-B, Bencer, and Frice were prepared by distilled water in 2 mg/ml and 4 mg/ml and added to pits in cultures medium. Then, the samples were incubated at 37°, C for 24-48 hours and diameter of the antibacterial inhibitory haloarchaea was reported in millimeters. T-test was used for statistical analysis. Results: All dentifrices recorded an inhibitory haloarchaea diameter of 3-25 mm (except Bath and Irox at 2 mg/ml against S. mutans, 0 mm). The antibacterial strength of dentifrices was as follows: OralB> Colgate> Frice> Bencer> Misswake> Bath> Irox. At 4 mg/ml, the diameter of haloarchaea against L. acidophilus was approximately twice than that of S. mutans. The mean haloarchaea diameter was not significantly different between the control group and dentifrices at 4 mg/ml against S. mutans (P= 0. 080). In other conditions, the mean diameter of haloarchaea in dentifrices was lower than that of the control group (P≤, 0. 001). Conclusion: In this in-vitro study, Oral-B and Colgate (sodium fluoride 500 ppm) had the highest antibacterial effect and Bath and Irox (sodium monofluorophosphate 500 ppm) had the lowest antibacterial strength against the studied microorganisms. In addition, except for Bath and Irox, other dentifrices in various concentrations had desirable antibacterial properties.

Background and purpose: Enamel demineralization around orthodontic brackets is a significant problem. This study aimed to compare the efficacy of Casein phosphopeptide amorphous calcium phosphate (CPP-ACP) varnish and fluoride varnish in preventing enamel demineralization around and beneath orthodontic brackets. Materials and methods: Twenty extracted premolars were randomly divided into two groups and orthodontic brackets were bonded to their buccal surface by composite. The amount of fluorescent light reflected back from the enamel at the mesial and distal of the bracket was measured using a DIAGNOdent™,pen. MI varnish (CPP-ACP) was applied on the exposed enamel of the distal half of the teeth in group I while FluoroDose varnish was applied on the same area in group II. The mesial half of the teeth served as the control group. All teeth underwent two demineralization cycles and after each cycle, enamel demineralization was quantified at mesial and distal areas (T1, T2). The brackets were then debonded, and area under the brackets was also measured by DIAGNOdent™,pen (T3). Data were analyzed using repeated measures ANOVA and paired t-test. Results: In both groups, significant difference was noted between the mesial and distal areas in degree of demineralization at T2 (P<0. 001), but both of the varnishes had no effect on the degree of demineralization. Conclusion: FluoroDose varnish and MI varnish were equally effective for enhancement of enamel resistance to demineralization with no superiority over each other.

Background and purpose: Postoperative nausea and vomiting is a common complication of anesthesia. The aim of this study was to compare the effect of midazolam, ondansetron and their combination in prevention of nausea and vomiting after strabismus surgery. Materials and methods: In this randomized double-blind clinical trial, 140 patients undergoing strabismus surgery were divided into four groups (n=35 per group). The patients received midazolam 0. 75 mg/kg (M), ondansetron 4 mg (O), midazolam 0. 75 mg/kg + ondansetron 4 mg (MO), and saline 0. 9% iv. (S) before anesthesia. Follow-up was done in the first 24 hours after surgery and incidence and severity of nausea and vomiting and other postoperative complications were compared between the four groups. Results: In this study, 10 patients (37%) in group S, 6 (19. 4%) in group O, 8 (28. 6%) in group M, and 2 (6. 3%) in group MO developed nausea indicating significant differences between the four groups (P=0. 019). The study showed no significant differences between the groups in incidence of vomiting (P= 0. 18),6 patients (22. 2%) in group S, 5 (16. 1%) in group O, 4 (14. 3%) in group M, and 1 patient (3. 1%) in group MO had vomiting. The severity of postoperative nausea and vomiting was significantly different between the four groups and group MO was found to have less severe nausea and vomiting two hours (P= 0. 009) and 24 hours after surgery (P< 0. 001). Conclusion: Combination of midazolam and ondansetron reduces the incidence of postoperative nausea and vomiting compared to midazolam or ondansetron alone and leads to greater patient satisfaction. According to the higher effect of MO and lack of adverse effects on hemodynamic parameters it is recommended in patients undergoing strabismus surgery.

Background and purpose: Borderline personality disorder is a common mental disorder that is associated with high suicide rates, severe functional impairment, high rates of associated mental disorders, overuse of treatment, and high costs to society. The aim of this study was to evaluate the effectiveness of analytical psychotherapy based on transference-focused psychoanalysis on neuroticism and impulsivity in people with borderline personality. Materials and methods: A quasi-experimental study with A-B-A design was carried out and the study population included patients (n=32) with borderline personality disorder attending the outpatient department in Zare Psychiatric Hospital and Mana House Clinic in Sari, between May and June 2020. Seven patients were selected by available sampling and were randomly allocated into an experimental group (n=4) and a control group (n=3) and were treated for one year. Barratt Impulsiveness Scale (2004) and NEO Personality Inventory (2004) were administered. Statistical analysis was performed using graph analysis, stable change, and recovery rate. Results: Findings showed that transference-focused psychotherapy can be effective on neuroticism and impulsivity in people with borderline personality. Conclusion: The treatment outcome is not success versus failure, however, it may include improvements in a number of functional areas. Further research is also needed to generalize current findings.

Background and purpose: Osteoarthritis and osteoporosis are the most important causes of skeletal disorders and there are controversies over the relationship between these diseases and other factors. The aim of the present study was to investigate the relationship between osteoarthritis and osteoporosis and also the association between these two diseases and patients’,demographic and lifestyle characteristics. Materials and methods: This cross-sectional study was performed in patients attending Sari hospitals in the fourth quarter of 2019 selected via census sampling. Knee radiography was performed and the severity of osteoarthritis joint was determined based on Kellgren-Lawrence criterion. Bone mineral density (BMD) was also measured by DXA scan. Data was collected using demographic questionnaire and lifestyle dimensions. Data were analyzed in SPSS V18. Results: A total of 77 patients were studied. The mean age of patients was 57. 3±, 10. 3 years and the majority were females (n= 73, 94. 8%). Severity of osteoarthritis was determined as mild in 28 (36. 36%), moderate in 31 (40. 26%), and severe in 18 (23. 38%) patients. The mean BMD level was 0. 76±, 0. 06 g/cm. There was a significant difference between the severity of osteoarthritis and BMD level (P=0. 008). Significant differences were found between patients with osteoarthritis and osteoporosis in age, sex, weight, and some lifestyle indicators (P<0. 05). Conclusion: Osteoarthritis of the knee joint is associated with osteoporosis. But, demographic and lifestyle characteristics could have a major role in the incidence of these diseases.

Background and purpose: There is little information about the prognostic role of preoperative serum albumin levels in postoperative outcomes following coronary artery bypass grafting (CABG). The aim of this study was to evaluate preoperative hypoalbuminemia as a predictor for complications after CABG. Materials and methods: This prospective observational study was conducted in 200 patients undergoing CABG in Ahvaz Golestan Hospital, 2020. The patients were classified into two groups based on pre-operative hypoalbuminemia (serum Alb <3. 5 g/dL). The association between hypoalbuminemia and clinical characteristics and outcomes including postoperative complications, ventilator duration, and length of hospital stay was assessed. Results: Preoperative hypoalbuminemia was observed in 38 (19%) patients. Patients with hypoalbuminemia had higher postoperative complications including hemorrhage, infection, cardiac arrest, AKI, and in-hospital mortality than patients with normal albumin levels (84. 2% vs. 13%, P<0. 0001). Ventilator duration, length of hospital stay and ICU were significantly longer in hypoalbuminemia patients than normal albumin group (P<0. 0001). Preoperative hypoalbuminemia (P<0. 0001), ventilator duration (P=0. 025), and length of hospital stay (P=0. 002) were independent predictors of CABG postoperative complications. Conclusion: Preoperative hypoalbuminemia was associated with postoperative mortality and complications, including hemorrhage, infection, stroke, and AKI development in patients undergoing CABG procedure. Thus, serum albumin measurement before CABG as a clinically implementable and easy method could be used for management and prevention of postoperative complications.

Background and purpose: Coronaviruses are a type of virus that can cause death due to pneumonia and respiratory problems. Pregnant women are at higher risk for developing COVID-19 and the disease has posed challenges to anesthesia in these patients. The aim of this study was to evaluate the consequences of general anesthesia and spinal anesthesia in expectant mothers with COVID-19 candidates for cesarean section. Materials and methods: This descriptive-analytical study was performed in 80 pregnant women with COVID-19 candidates for cesarean delivery in Sari Imam Khomeini Hospital and Qaemshahr Razi Hospital, 2021. The expectant mothers underwent general (n= 40) or spinal anesthesia (n= 40). A researcher-made checklist was completed before, during, and after the delivery. Data were analyzed applying Chi-square, Mann-Whitney, T-test, One-way analysis of variance, and repeated measure ANOVA. Results: No significant difference was found between the two groups in demographic characteristics (P> 0. 05), but there was a significant difference between urgent surgery and the type of anesthesia (P <0. 05). Significant differences were seen in heart rate and mean oxygen saturation between the two groups (P= 0. 0001 and P< 0. 05, respectively). Nausea and vomiting, and chills were observed to be more common during spinal anesthesia (P= 0. 007 and P= 0. 002). Changes in systolic and diastolic blood pressure occurred more in spinal anesthesia group than the general anesthesia group (P= 0. 0001). Conclusion: Both general anesthesia and spinal anesthesia in mothers with COVID-19 can be safe for both the mother and baby if carefully planned and performed by experienced anesthesiologists.

Background and purpose: Moral distress is a stressful experience in the face of clinical decision making that causes severe psychological stress. This common phenomenon occurs when a person cannot take appropriate action despite being aware of that. Nursing students are also exposed to moral damage during clinical education, so, this study was conducted to investigate moral distress and related factors in nursing students. Materials and methods: In a descriptive correlational study, 350 nursing students in Mazandaran University of Medical Sciences participated in 2019. They were selected via available sampling. Demographic information and educational information were recorded, and Moral Distress Scale-Revised (MDS-R) was completed. In this scale, the scores range from zero to 336 and a high score indicates a higher level of moral distress. The scale examines moral distress from two aspects,frequency of an event and its severity. Data analysis was done using SPSS V25. Results: The mean score for moral distress in nursing students was 78. 59±, 35. 79. The mean score for frequency of moral distress was 31. 66±, 10. 05 and the mean score for the intensity of moral distress was 42. 76±, 13. 38. Findings showed low levels of moral distress in nursing students. Linear regression analysis also showed a significant relationship between moral distress and age, place of residence, and type of residence (P= 0. 0010, r = 0. 09). Conclusion: Moral distress is experienced by nursing students, therefore, clinical education 2 programs should focus on morally stressful events and help the students to cope and reduce any negative consequences.

Background and purpose: Adherence to treatment has a key role in management of hypertension and mobile phones can be used to educate patients. The aim of this study was to investigate the effect of a mobile educational application on adherence to treatment in elderly with hypertension. Materials and methods: This randomized clinical trial was conducted in Neishabour, Iran 2020. A total of 54 retired elderly patients who were members of the Retirement Association were selected by consecutive sampling and were randomly divided into an intervention group (n= 27) and a control group (n= 27). Data were collected using demographic questionnaire and Adherence to Treatment Scale by Modanloo et al. (2013). The intervention was performed using an educational application in the intervention group, six sessions/three weeks and the control group was provided with routine care. Adherence to Treatment Scale was completed by both groups before and six weeks after the intervention. Results: The findings showed significant differences between the intervention group and the control group in mean score for commitment to treatment (P= 0. 023) and hesitation in implementation of treatment (P= 0. 026). Before the intervention, the mean values for systolic and diastolic blood pressure were not significantly different between the two groups, but after the intervention, the mean diastolic blood pressure was found to be significantly lower in the intervention group (P= 0. 017). Conclusion: The rate of adherence to treatment is increased through mobile educational applications, and this can be used to manage chronic diseases and promote adherence to medication and treatment.

Background and purpose: Futile medical care is referred to any medical intervention or activity that bring no benefit to patients. The aim of this study was to evaluate the frequency of futile treatment and its cost in neonates with a probable diagnosis of inherited metabolic disorder. Materials and methods: In this cross-sectional study, hospitalization records of all admitted neonates in Children's Medical Center, Tehran were evaluated between 2013 and 2016. Demographic characteristics of the patients, duration of hospitalization, diagnostic and therapeutic management, and costs were investigated. Results: In the period studied, 1668 neonates were hospitalized of whom 20 (1. 2%) died in neonatal intensive care unite with a probable diagnosis of inherited metabolic disorder. Six (30%) cases had deceased siblings. The total duration of hospitalization was 290 day-patient ranging from 20 hours to 37 days. The costs of hospitalization and medical treatments were calculated. Despite disagreement of eight (40%) parents with any futile treatments, the medical team discontinued the futile care in only one case who received palliative care. In other patients futile treatment continued before death. Conclusion: Futile medical treatments in neonates with inherited metabolic disorders are not uncommon. Lack of a comprehensive guideline about this issue leads to continuation of futile medical care.

Background and purpose: The COVID-19 pandemic has widely forced universities to provide electronic education, so, it is necessary to examine the quality of this type of education. The aim of this study was to investigate the quality of virtual learning during COVID-19 pandemic from the perspective of dental students in Mazandaran University of Medical Sciences. Materials and methods: A descriptive-analytical cross-sectional study was performed and dental students in Mazandaran University of Medical Sciences who studied via on-line courses in 2020/21 academic year were included. A researcher-made questionnaire was used consisting of five components: implementation method, facilities and technology, content, strategies and methods, and evaluation. Results: In this study, 128 students completed the questionnaire. According to findings, in first semester, the status of some components, including implementation method, content, strategies and methods, and evaluation were unfavorable, but facilities and technology were found to be relatively favorable. Also, in second semester, the situation of strategies and methods was unfavorable, and the rest of the components had a relatively favorable condition. Female students were more satisfied with the quality of virtual learning. Conclusion: In general, the quality of virtual learning in Mazandaran School of dentistry was unfavorable in 2020, but became relatively favorable later. Despite improvements in 2021, special attention should be paid to this modern educational method.

Background and purpose: Textile industries produce huge amounts of colored wastewater. Synthetic dyes cause serious problems to human health and aquatic organisms due to their toxic and carcinogenic properties. In this study, Acid Blue 113 (AB113), which is stable and persistent against conventional treatment methods was selected as the target contaminant. Materials and methods: The synthesis of the ZnO-Kaolin nanocomposite was performed by simple co-precipitation approach. The crystalline structure, functional groups, morphology, and elemental composition of the prepared samples were characterized using XRD, FT-IR, SEM and EDX analyses, respectively. Next, the photocatalytic response was evaluated via degradation of AB113 dye under visible irradiation. Also, the influences of operating parameters, including pH, catalyst value, initial AB113 concentration, various gases, organic compound types, and catalyst recycling on the photocatalytic performance were studied in a batch reactor. Results: The SEM analysis confirmed the ZnO-Kaolin spherical structure. Presence of organic compounds in the aqueous medium decreased AB113 removal efficiency. The highest removal efficiency (84. 33%) was obtained at catalyst loading=0. 4 g. L-1, initial dye concentration=20 mg. L-1, and pH=7. Compared with ZnO and Kaolin nanoparticles, the resulting catalyst (ZnO-Kaolin) exhibited significantly improved photocatalytic activity in AB113 degradation. The degradation of AB113 was found to follow the first order kinetic (Kobs: 0. 122 min-1 and R 2: 0. 9516) and the Langmuir-Hinshelwood model (KC: 0. 278 mg. L-1. min-1 and KAB113: 0. 128 L. mg-1 ). Conclusion: The proficient performance of the LED/ZnO-Kaolin system illustrated that it can be used for practical applications in water treatment.

Background and purpose: Autoimmune hepatitis is a chronic liver inflammatory disease of unknown etiology that is more common in women. The goal of this study was to investigate the clinical, histopathological, laboratory, and elastography findings and outcome in patients with autoimmune hepatitis and verifying the factors associated with treatment response in Sari, Iran. Materials and methods: This research is a descriptive study in which demographic, clinical, histopathological, laboratory and elastographic information of 136 autoimmune hepatitis patients referred to Imam Khomeini Hospital and specialized gastrointestinal clinics in Sari during the years 2019-2021 was recorded in a pre-designed questionnaire. Results: In the study of the relationship between demographic, laboratory, histopathological, elastographic, and clinical factors with response to treatment, only prothrombin time (PT) and platelet (PLT) count had a significant relationship with response to treatment (p < 0. 05). In fact, thrombocytopenia and high PT led to poor treatment response and high PT was associated with a higher probability of recurrence. There was also a significant relationship between cirrhosis and non-cirrhosis at the time of diagnosis with response to treatment (p < 0. 05). People with cirrhosis experienced less response to treatment. None of the factors mentioned were related to the new cirrhosis (p < 0. 05). In the study of the relationship between the results of the initial and subsequent liver fibroscan during the follow-up, the reduction of fibrosis following treatment was clearly seen. Conclusion: Liver elastography is recommended for fibrosis evaluation during treatment and follow-up.

Background and purpose: Lactoferrin is found in mucus, milk, and colostrum secretions and has antimicrobial activities, improves iron absorption, and enhances immune responses. Lactoferrin has the ability to degrade starch. The aim of this study was to investigate the preservation of milk lactoferrin enzymatic activity after purification by ion exchange chromatography. Materials and methods: In this experimental research, fat and casein were removed from camel milk and lactoferrin was purified by ion exchange chromatography using CM-Sephadex-C-50. Km and Vmax values of lactoferrin amylase activity, pH, and optimum reaction temperature were determined. For this purpose, 0. 5% solution of cornstarch was used as a substrate and iodine activity test was used to determine the unused amounts. The optimum temperature for amylase activity was determined by paper chromatography. Results: The presence of lactoferrin was seen at about 73 KD and its average concentration was 60 µ, g/ml. Km and Vmax values were 2mg. ml-1 and 0. 2 mg. ml-1. min-1, respectively. Lactoferrin also showed extensive amylase activity in pH 4-7 and had the highest activity at pH 5. The amylase activity of lactoferrin reached its maximum at 40°, C. Enzymatic digestion caused hydrolysis of starch and its conversion to maltose and glucose. Conclusion: According to the present study, ion exchange chromatography could isolate high purity lactoferrin. High amylase activity of lactoferrin showed that its protein structure was preserved after passing through the chromatographic column.

Background and purpose: Despite wide fight against malaria in endemic regions, it is still one of the most serious infectious diseases in some parts of the world. Primakin is effective in treatment and prevention of malaria. However, individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency are at risk for hemolysis and its complications when taking primakin. This study was performed to determine the prevalence of G6PD deficiency in patients suspected of favism in Qaleh Ganj, Kerman, Iran. Materials and methods: This study was conducted in 2020 and blood samples were taken from all patients suspicious of favism attending Shohada Hospital in Qaleh Ganj, southern Iran. The G6PD enzyme activity was evaluated by fluorescent spot test using a commercial kit. Data were analyzed using SPSS V23. Results: In this study, 235 patients (88 males and 147 females) were examined. Fifty eight people (24. 7%) had abnormal levels (deficiency) of G6PD enzyme, 38 (65. 6%) of whom had severe deficiency and 20 (34. 4%) had partial deficiency. No significant relationship was found between sex and G6PD level (P= 0. 96). Conclusion: The study showed a high prevalence of G6PD deficiency in this region. So, attention should be paid to this issue when prescribing oxidative drugs, especially antimalarial drugs.

Background and purpose: Low quality of life and complications of high blood sugar are among the problems of patients with diabetes. This study aimed to compare the effect of patient-centered education and family-centered education on quality of life and HBA1C in patients with type 2 diabetes. Materials and methods: A clinical trial was performed in diabetic patients in Rafsanjan Diabetes Clinic. The sample size was 120, who were randomly assigned into three groups: patientcentered intervention, family-centered intervention, and control. Participants in family-centered intervention and patient-centered intervention groups attended 1-hour training program in 12 sessions and the control group received routine care. In the family-centered intervention group, in addition to the patient, a family member attended the training sessions. Data were collected using SF-36 quality of life questionnaire and measuring HBA1C before the intervention and after 12 weeks. Results: Before the intervention, no significant difference was found between the three groups in quality-of-life score and HBA1C (P>0. 05). But after the intervention, the quality-of-life was seen to be significantly different between the three groups (P=0. 001(. The mean HBA1C level was not significantly different between the three groups after the intervention (P=0. 187). Conclusion: Educational programs in patients with type 2 diabetes and their families can improve their quality of life and are recommended to be implemented by health care professionals.

Background and purpose: Cranioplasty after craniotomy is done to repair the skull and in some cases decompressive craniectomy is performed. Previous studies showed that the incidence of complications after cranioplasty is associated with the time of occurrence. The aim of this study was to compare the rate of complications between early cranioplasty (EC) and late cranioplasty (LC) in craniectomy patients in Kerman Shahid Bahonar Hospital, 2015-2018. Materials and methods: In a retrospective cohort study, patients’,records were studied and the subjects were matched for age and sex. Then, frequency of complications was compared between patients with EC (n=45) and LC (n=46). Data analysis was applied in SPSS V25. Results: There were no significant differences between the two groups in age and sex (P= 0. 846 and P= 0. 185, respectively). The most common indication for craniotomy was subdural hemorrhage and the most common complication was hematoma. No significant association was found between the indication for surgery and type of cranioplasty (P=0. 493). The two groups did not have significant differences in Glasgow Coma Scale (GCS) score before and after the surgery (P=0. 841 and P=0. 148, respectively) and were found to be similar in frequency of complications (P>0. 05), including hematoma (three cases in each group), hydrocephalus (two cases in EC and one case in LC), and wound healing impairment (two cases in EC). Conclusion: According to current study, neurosurgeons, depending on the patient's condition, can use either EC or LC.

Background and purpose: Nowadays, plants are more available and many are used for treatment purposes, therefore, the rate of poisoning by plants has increased. According to the geographical location of Isfahan in Iran, the present study aimed at investigating this problem since there is paucity of information about plant poisoning in the region. Materials and methods: In this cross-sectional study, patient data poisoned with poisonous plants were collected from Khorshid Hospital (a referral center for poisoning) in Isfahan between 2010 and 2019. Demographic and clinical, paraclinical and, therapeutic information were studied. Results: In 72 patients with plant poisoning, the most common cause was unknown plants (29%) followed by castor seed poisoning (22. 2%) and datura (16. 6%). The majority of patients were male (60%) and the highest rate of poisoning occurred in people aged 20-39 years old. Conscious poisoning was most often reported to be with datura (46. 7%) in patients of 10-19 years old, while accidental poisoning was found to be more common with unknown plants (34. 1%) in children (0-9 years of age). Poisoning due to treatment purposes was seen manily by unknown plants and castor seeds (61. 6%). Suicide by self-poisoning was mainly done by oleander (66. 7%). At admission, patients with datura poisoning often had tachycardia (58%) and mydriasis pupils (91%). In patients with castor bean poisoning, gastrointestinal symptoms were more frequent (nausea and vomiting in 94%). Most of the patients were discharged within 24 hours after admission. None of the patients needed antidote and intubation and all were discharged with supportive treatment and complete recovery. Conclusion: Most of the cases studied had mild symptoms and only needed supportive care.